2021 Volume 36 Issue 1 Pages 24-34
For the perioperative management, acute and chronic postsurgical pain (CPSP) are the urgent medical matters to be considered. The International Association for the Study of Pain (IASP) has named 2017 as the Global Year Against Pain After Surgery where they focused on the pain after surgery. As one of various aspects of postsurgical pain, they had published fact sheet named “Chronic Postsurgical Pain (CPSP): Definition, Impact, and Prevention”. In the fact sheet, they had concluded that “prediction of CPSP might in theory allow preemptive targeting of individual patients at risk”. Pain catastrophizing scale (PCS) could be one of predictive factors for CPSP. As other predictive factors, endogenous pain modulation, such as conditioned pain modulation (CPM) and temporal summation of pain (TSP) has been reported. In addition, offset analgesia (OA) has been considered to represent the endogenous pain modulation recently. However, it remains unclear whether these preoperative evaluations could lead to the prediction of acute and chronic postsurgical pain. We have developed the portable measurement device for the evaluation of endogenous pain modulation such as CPM, TSP and OA. With the developed device, CPM, TSP and OA were tested in healthy volunteers and patients scheduled for orthognathic surgery. In addition, PCS scores were recorded preoperatively. The data showed that the preoperative evaluation of CPM, PCS and OA would lead to the prediction of patients at risk for postsurgical pain.
