The Impact of Anesthesiologists on Mitigating Chronic Post-Surgical Pain and Opioid Dependence Through Neurobiological Strategies: A Brief Review - Summary - MDSpire
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The Impact of Anesthesiologists on Mitigating Chronic Post-Surgical Pain and Opioid Dependence Through Neurobiological Strategies: A Brief Review
To synthesize evidence on perioperative risk factors, mechanistic pathways, and anesthetic/analgesic interventions to influence the development of Chronic Post-Surgical Pain (CPSP) and Chronic Opioid Use (COU), highlighting their significance in public health.
Key Findings:
Chronicity of CPSP is predictable based on preoperative psychosocial factors such as anxiety and catastrophizing.
Key mechanisms include central sensitization, neuroinflammation, epigenetic changes, and gut-brain axis disruption.
Regional anesthesia and targeted systemic non-opioids are effective in preventing CPSP and reducing opioid consumption, particularly in high-risk surgeries.
Interpretation:
CPSP and COU require a precision medicine approach that considers individual variability, necessitating thorough preoperative risk stratification and targeted analgesia, with practical implementation strategies.
Limitations:
The review is limited to studies published until December 2025, which may not include the most recent findings.
Potential biases in the selected studies may affect the generalizability of the findings, including publication bias.
Conclusion:
Anesthesiologists can play a crucial role in preventing CPSP and COU through tailored perioperative strategies that address neurobiological programming, emphasizing their importance in the broader healthcare context.
