Modern components and challenges of a multimodal approach to the prevention of chronic post-operative pain syndrome: a literature review



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

This literature review analyzes current components of the multimodal approach (MMA) for preventing chronic post-surgical pain (CPSP). The prevalence of this complication ranges from 5% to 75% depending on the surgical intervention type. Authors searched PubMed, Ovid MEDLINE, Google Scholar, and ScienceDirect, selecting 90 publications from 2015–2025. The work examines key MMA components, including regional anesthesia (PECS 2 and paravertebral blocks), pharmacological methods (NSAIDs, gabapentinoids, NMDA receptor antagonists, intravenous lidocaine infusion), and non-pharmacological methods (physiotherapy, cryotherapy, electroanalgesia, cognitive-behavioral therapy). The combination of these methods effectively controls acute post-surgical pain, minimizes the risk of chronification, and reduces opioid burden. Special attention is given to promising techniques, particularly intravenous lidocaine infusion, which showed a significant reduction in CPSP incidence. However, variability in the effectiveness of different components based on surgery type and individual patient characteristics, including psychological and genetic factors, was noted. The authors concluded the necessity for further multicenter randomized trials to develop personalized clinical protocols and an interdisciplinary approach for integrating multimodal strategies into clinical practice, especially in the early postoperative period.

Full Text

Restricted Access

References

  1. Lopes A, Menezes MS, Barros GAMD, et al. Chronic postoperative pain: ubiquitous and scarcely appraised – narrative review. Brazilian Journal of Anesthesiology. 2021;71(6):649–655. doi: 10.1016/j.bjane.2020.10.014
  2. Vysotskaya AV, Khiddzhas NR. Postoperative pain syndrome in patients with surgical pathology. 2022. (In Russ.) URL: https://elib.gsmu.by/bitstream/handle/GomSMU/12120/6–8.pdf?sequence=1&isAllowed=y
  3. Morozov AM, Sergeev AN, Kadykov VA, et al. Chronic pain syndrome, risk factors for development at the stages of surgical intervention. Siberian Medical Review. 2021;(5):5–13. (In Russ.) doi: 10.20333/25000136-2021-5-5-13
  4. Popov MO, Kinzhalova SV, Davydova NS, et al. Mechanisms of postoperative pain syndrome development in gynecological patients. Ural Medical Journal. 2023;22(6):94–103. (In Russ.) doi: 10.52420/2071-5943-2023-22-6-94-103
  5. Elsharkawy H, Clark JD, El-Boghdadly K, et al. Evidence for regional anesthesia in preventing chronic postsurgical pain. Regional Anesthesia & Pain Medicine. 2025;50(2):153–159. doi: 10.1136/rapm-2024-105611
  6. Zagorulko OI, Medvedeva LA, Churyukanov MV. The problem of chronic postoperative pain. Surgery. The Journal Named After N.I. Pirogov. 2021;(6-2):84. (In Russ.) doi: 10.17116/hirurgia202106284
  7. Chen YY, Boden KA, Schreiber K, et al. The role of regional anaesthesia and multimodal analgesia in the prevention of chronic postoperative pain: a narrative review. Anaesthesia. 2021;76(Suppl 1):8–17. doi: 10.1111/anae.15256
  8. Kianian S, Bansal J, Lee C, Zhang K, et al. Perioperative multimodal analgesia: a review of efficacy and safety of the treatment options. Anesthesiology and Perioperative Science. 2024;2(1):9. doi: 10.1007/s44254-023-00043-1
  9. Lopes A, Menezes MS, Barros GAMD. Chronic postoperative pain: ubiquitous and scarcely appraised - narrative review. Brazilian Journal of Anesthesiology. 2021;71(6):649-655. https://doi.org/10.1016/j.bjane.2020.10.014
  10. Wu H, Ding T, Yan S, et al. Risk factors for moderate-to-severe postoperative pain after percutaneous nephrolithotomy: a retrospective cohort study. Scientific Reports. 2022;12:8366. https://doi.org/10.1038/s41598-022-12623-5
  11. Jin J, Peng L, Chen Q, et al. Prevalence and risk factors for chronic pain following cesarean section: a prospective study. BMC Anesthesiology. 2016;16(1):99. https://doi.org/10.1186/s12871-016-0270-6
  12. Cheng Z, Li J, Wu W, et al. Developing and validating a machine learning model to predict chronic pain following total knee arthroplasty. The Knee. 2025;56:52-65. https://doi.org/10.1016/j.knee.2025.05.011
  13. George SZ, Bolognesi MP, Bhavsar NA, et al. Chronic pain prevalence and factors associated with high impact chronic pain following total joint arthroplasty: an observational study. The Journal of Pain. 2022;23(3):450-458. https://doi.org/10.1016/j.jpain.2021.09.007
  14. Wu Q, Cui X, Guan LC, et al. Chronic pain after spine surgery: Insights into pathogenesis, new treatment, and preventive therapy. Journal of Orthopaedic Translation. 2023;42:147-159. https://doi.org/10.1016/j.jot.2023.07.003
  15. Stukalov AV, Lakhin RE, Gritsai AN, et al. Chronic post-thoracotomy pain syndrome in cardiothoracic surgery after minimally invasive coronary artery bypass grafting: a prospective cohort study. Regional Anesthesia and Acute Pain Management. 2022;16(4):279-288. (In Russ.) https://doi.org/10.17816/RA112304
  16. Tsedinova YB, Churyukanov MV, Zagorulko OI, et al. Risk factors for chronic postoperative pain in cardiac surgery: psychological characteristics and central sensitization. Russian Journal of Pain. 2023;21(4):32. (In Russ.) https://doi.org/10.17116/pain20232104132
  17. Ellyson AM, Gordon G, Zhou C, et al. Trajectories, risk factors, and impact of persistent pain after major musculoskeletal surgery in adolescents: a replication study. The Journal of Pain. 2022;23(6):995-1005. https://doi.org/10.1016/j.jpain.2021.12.009
  18. Kurushina OV, Shkarin VV, Ivasheva VV, et al. Problems of studying chronic pain epidemiology in the Russian Federation. Russian Journal of Pain. 2022;20(3):31-35. (In Russ.) doi: 10.17116/pain20222003131
  19. Medvedeva LA, Zagorulko OI, Belov YV. Chronic postoperative pain: current state of the problem and stages of prevention. Anesthesiology and Reanimatology. 2017;62(4):305-309. (In Russ.) DOI: http://dx.doi.org/10.18821/0201-7563-2017-62-4-305-309
  20. Vorobyova NM, Manevich TM, Tkacheva ON, et al. Prevalence and characteristics of chronic pain syndrome in people over 65 years: data from the Russian Eucalyptus epidemiological study. Russian Journal of Geriatric Medicine. 2021;(4):425-434. (In Russ.) doi: 10.37586/2686-8636-4-2021-425-434
  21. Wang L, Yang M, Meng W. Prevalence and characteristics of persistent postoperative pain after thoracic surgery: a systematic review and meta-analysis. Anesthesia & Analgesia. 2023;137(1):48-57. doi: 10.1213/ANE.0000000000006452
  22. Tyurina EA, Zagorulko OI, Medvedeva LA, et al. Analysis of pain chronicization factors in the postoperative period in abdominal surgery. Clinical and Experimental Surgery. 2022;10(1)(35):108-113. (In Russ.) doi: 10.33029/2308-1198-2022-10-1-108-113
  23. Rosenberger DC, Pogatzki-Zahn EM. Chronic post-surgical pain - update on incidence, risk factors and preventive treatment options. BJA Education. 2022;22(5):190-196. doi: 10.1016/j.bjae.2021.11.008
  24. Churyukanov MV, Shevtsova GE, Zagorulko OI. Postoperative pain syndrome: current concepts and solutions. Russian Journal of Pain. 2018;(1):78-87. (In Russ.) doi: 10.25731/RASP.2018.01.011
  25. Jin J, Zhang T, Xiong X, et al. A prospective study of chronic postsurgical pain in elderly patients: incidence, characteristics and risk factors. BMC Geriatrics. 2023;23(1):289. doi: 10.1186/s12877-023-04006-w
  26. Gumenyuk LN, Seitumerova LI, Serafimova AA, et al. Imbalance of neurotransmitter systems and psychological dysfunctions as predictive factors of postoperative chronic pain syndrome in operative gynecology. Ulyanovsk Medical and Biological Journal. 2020;(2):48–56. (In Russ.) doi: 10.34014/2227-1848-2020-2-48-56
  27. Siracusa R, Monaco F, D’Amico R, et al. Epigallocatechin-3-gallate modulates postoperative pain by regulating biochemical and molecular pathways. International Journal of Molecular Sciences. 2021;22(13):6879. https://doi.org/10.3390/ijms22136879
  28. Karcz M, Abd-Elsayed A, Chakravarthy K, et al. Pathophysiology of pain and mechanisms of neuromodulation: a narrative review (A Neuron Project). Journal of Pain Research. 2024:3757–3790. https://doi.org/10.2147/JPR.S475351
  29. Nikitas J, Yanagawa J, Sacks S, et al. Pathophysiology and management of chest wall pain after surgical and non-surgical local therapies for lung cancer. JTO Clinical and Research Reports. 2024;5(7):100690. https://doi.org/10.1016/j.jtocrr.2024.100690
  30. Carrascosa AJ, Navarrete F, Saldaña R, et al. Cannabinoid analgesia in postoperative pain management: From molecular mechanisms to clinical reality. International Journal of Molecular Sciences. 2024;25(11):6268. https://doi.org/10.3390/ijms25116268
  31. Likar R, Poglitsch R, Bejvančický Š, et al. The use of high-dose intravenous L-ascorbate in pain therapy: current evidence from the literature. Pain and Therapy. 2024;13(4):767–790. https://doi.org/10.1007/s40122-024-00622-5
  32. Medvedeva LA, Zagorulko OI, Belov YV. Chronic postoperative pain: Current state of the problem and stages of prevention. Anesteziologiya i Reanimatologiya (Anesthesiology and Reanimatology). 2017;62(4):305–309. (In Russ.) doi: 10.18821/0201-7563-2017-62-4-305-309
  33. Medvedeva LA, Zagorulko OI. Stages of prevention of postoperative pain chronification. Clinical and Experimental Surgery. 2016;4(4)(14):77–84. (In Russ.)
  34. Tsedinova YB, Churyukanov MV, Medvedeva LA, et al. Psychological characteristics of patients with chronic postoperative pain. Russian Journal of Pain. 2020;18(2):29–33. (In Russ.) doi: 10.17116/pain20201802129
  35. Klatt E, Zumbrunn T, Bandschapp O, et al. Intra- and postoperative intravenous ketamine does not prevent chronic pain: A systematic review and meta-analysis. Scandinavian Journal of Pain. 2015;7(1):42–54. https://doi.org/10.1016/j.sjpain.2014.12.005
  36. Ovechkin AM, Zvizhuleva AA. Postoperative analgesia in plastic surgery. Regional Anesthesia and Acute Pain Management. 2016;10(2):82–96. (In Russ.) doi: 10.18821/1993-6508-2016-10-2-82-96
  37. Fujii T., Shibata Y., Akane A., et al. A randomised controlled trial of pectoral nerve-2 (PECS 2) block vs. serratus plane block for chronic pain after mastectomy. Anaesthesia. 2019;74(12):1558–1562. https://doi.org/10.1111/anae.14856
  38. Li X.L., Zhang Y., Dai T., et al. The effects of preoperative single-dose thoracic paravertebral block on acute and chronic pain after thoracotomy: A randomized, controlled, double-blind trial. Medicine. 2018;97(24):e11181. doi: 10.1097/MD.0000000000011181
  39. Borys M., Hanych A., Czuczwar M. Paravertebral block versus preemptive ketamine effect on pain intensity after posterolateral thoracotomies: a randomized controlled trial. Journal of Clinical Medicine. 2020;9(3):793. https://doi.org/10.3390/jcm9030793
  40. Brummett C.M., Waljee J.F., Goesling J., et al. New persistent opioid use after minor and major surgical procedures in US adults. JAMA Surgery. 2017;152(6):e170504. doi: 10.1001/jamasurg.2017.0504
  41. Theodoraki K., Papacharalampous P., Tsaroucha A., et al. The effect of transversus abdominis plane block on acute and chronic pain after inguinal hernia repair. A randomized controlled trial. International Journal of Surgery. 2019;63:63–70. https://doi.org/10.1016/j.ijsu.2019.02.007
  42. Al Ja’bari A., Robertson M., El-Boghdadly K., et al. A randomised controlled trial of the pectoral nerves-2 (PECS-2) block for radical mastectomy. Anaesthesia. 2019;74(10):1277–1281. https://doi.org/10.1111/anae.14769
  43. Genov P.G., Timerbaev V.Kh., Grin A.A., et al. Choice of perioperative multimodal analgesia in patients with lumbar intervertebral disc herniation: Preliminary results. Anesthesiology and Reanimatology. 2016;(3):214–219. (In Russ.) doi: 10.18821/0201-7563-2016-3-214-219
  44. Hussain N., Grzywacz V.P., Ferreri C.A., et al. Investigating the efficacy of dexmedetomidine as an adjuvant to local anesthesia in brachial plexus block: A systematic review and meta-analysis of 18 randomized controlled trials. Regional Anesthesia & Pain Medicine. 2017;42(2):184–196. https://doi.org/10.1097/AAP.0000000000000564
  45. Kaye A.D., Chernobylsky D.J., Thakur P., et al. Dexmedetomidine in enhanced recovery after surgery (ERAS) protocols for postoperative pain. Current Pain and Headache Reports. 2020;24(5):21. https://doi.org/10.1007/s11916-020-00853-z
  46. Regan M.C., Romero-Hernandez A., Furukawa H. A structural biology perspective on NMDA receptor pharmacology and function. Current Opinion in Structural Biology. 2015;33:68–75. https://doi.org/10.1016/j.sbi.2015.07.012
  47. Frank R.A., Grant S.G. Supramolecular organization of NMDA receptors and the postsynaptic density. Current Opinion in Neurobiology. 2017;45:139–147. https://doi.org/10.1016/j.conb.2017.05.019
  48. Laumet G., Chen S.R., Pan H.L. NMDA receptors and signaling in chronic neuropathic pain. In: The NMDA receptors. Cham: Springer International Publishing; 2017. P. 103−119. https://doi.org/10.1007/978-3-319-49795-2_6
  49. Peltoniemi M.A., Hagelberg N.M., Olkkola K.T., Saari T.I. Ketamine: a review of clinical pharmacokinetics and pharmacodynamics in anesthesia and pain therapy. Clinical Pharmacokinetics. 2016;55(9):1059−1077. https://doi.org/10.1007/s40262-016-0383-6
  50. Keiski M.A. Memantine: A safe and tolerable NMDA antagonist with potential benefits in traumatic brain injury. In: New therapeutics for traumatic brain injury. Academic Press; 2017. P. 253−271. https://doi.org/10.1016/B978-0-12-802686-1.00016-X
  51. Gupta A., Bah M. NSAIDs in the treatment of postoperative pain. Current Pain and Headache Reports. 2016;20(11):62. https://doi.org/10.1007/s11916-016-0591-7
  52. Karateev A.E., Nasonov E.L., Yakhno N.N., et al. Clinical guidelines "Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice." Modern Rheumatology. 2015;9(1):4−23. (In Russ.) https://doi.org/10.14412/1996-7012-2015-1-4-23
  53. Howard M.L., Isaacs A.N., Nisly S.A. Continuous infusion nonsteroidal anti-inflammatory drugs for perioperative pain management. Journal of Pharmacy Practice. 2018;31(1):66−81. https://doi.org/10.1177/0897190016665539
  54. Medvedeva L.A., Zagorulko O.I., Churyukanov M.V. The use of nonsteroidal anti-inflammatory drugs for the prevention of chronic postoperative pain. Clinical and Experimental Surgery. 2022;10(2):120−125. (In Russ.) https://doi.org/10.33029/2308-1198-2022-10-2-120-125
  55. Lee G.G., Park J.S., Kim H.S., Yoon D.S., Lim J.H. Clinical effect of preoperative intravenous non-steroidal anti-inflammatory drugs on relief of postoperative pain in patients after laparoscopic cholecystectomy: Intravenous ibuprofen vs. intravenous ketorolac. Annals of Hepato-Biliary-Pancreatic Surgery. 2022;26(3):251−256. https://doi.org/10.14701/ahbps.21-151
  56. Bhandage S.G., Kurki M.S., Sachdeva G., et al. Evaluation of efficacy of peri-operative administration of hydrocortisone and dexamethasone in prevention of post-operative complications in oral and maxillofacial surgeries. Revista Española de Cirugía Oral y Maxilofacial. 2018;40(4):163−168. https://doi.org/10.1016/j.maxilo.2018.01.001
  57. Arbukh D. Perioperative pain control. Bulletin of Anesthesiology and Resuscitation. 2020;17(4):85−93. (In Russ.) https://doi.org/10.21292/2078-5658-2020-17-4-85-93
  58. Thapa P., Euasobhon P. Chronic postsurgical pain: current evidence for prevention and management. The Korean Journal of Pain. 2018;31(3):155−173. https://doi.org/10.3344/kjp.2018.31.3.155
  59. Carley M.E., Chaparro L.E., Choinière M., et al. Pharmacotherapy for the prevention of chronic pain after surgery in adults: an updated systematic review and meta-analysis. Anesthesiology. 2021;135(2):304–325. https://doi.org/10.1097/ALN.0000000000003837
  60. Sugragan C., Sirintawat N., Kiattavornchareon S., et al. Do corticosteroids reduce postoperative pain following third molar intervention? Journal of Dental Anesthesia and Pain Medicine. 2020;20(5):281–291. https://doi.org/10.17245/jdapm.2020.20.5.281
  61. Sharma M., Gupta S., Purohit S., et al. The Effect of Intravenous Dexamethasone on Intraoperative and Early Postoperative Pain in Lumbar Spine Surgery: A Randomized Double-Blind Placebo-Controlled Study. Anesthesia: Essays and Researches. 2018;12(4):803–808. doi: 10.4103/aer.AER_115_18
  62. Nielsen R.V., Fomsgaard J., Mathiesen O., et al. The effect of preoperative dexamethasone on pain 1 year after lumbar disc surgery: a follow-up study. BMC Anesthesiology. 2016;16:112. https://doi.org/10.1186/s12871-016-0277-z
  63. Zozulya M.V., Lenkin A.I., Kurapeev I.S., et al. Analgesia after cardiac surgery. Anesteziologiya i Reanimatologiya [Anesthesiology and Reanimatology]. 2019;(5):38–46. (In Russ.) https://doi.org/10.17116/anaesthesiology201905138
  64. Liu B., Liu R., Wang L. A meta-analysis of the preoperative use of gabapentinoids for the treatment of acute postoperative pain following spinal surgery. Medicine. 2017;96(37):e8031. doi: 10.1097/MD.0000000000008031
  65. Rai A.S., Khan J.S., Dhaliwal J., et al. Preoperative pregabalin or gabapentin for acute and chronic postoperative pain among patients undergoing breast cancer surgery: a systematic review and meta-analysis of randomized controlled trials. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2017;70(10):1317–1328. https://doi.org/10.1016/j.bjps.2017.05.054
  66. Kim E., Raji M.A., Westra J., et al. Comparative effectiveness of pain control between opioids and gabapentinoids in older patients with chronic pain. Pain. 2024;165(1):144–152. doi: 10.1097/j.pain.0000000000003006
  67. Jones I.A., Piple A.S., Yan P.Y., et al. A double-blinded, placebo-controlled, randomized study to evaluate the efficacy of perioperative dextromethorphan compared to placebo for the treatment of postoperative pain: a study protocol. Trials. 2023;24:238. https://doi.org/10.1186/s13063-023-07240-0
  68. Creighton D.W., Kumar A.H., Grant S.A. Perioperative Multimodal Pain Management: an Evidence-Based Update. Current Anesthesiology Reports. 2019;9:295–307. https://doi.org/10.1007/s40140-019-00340-1
  69. Crocetti L. α2 Adrenoceptor: a Target for Neuropathic Pain Treatment. Mini-Reviews in Medicinal Chemistry. 2017. doi: 10.2174/1389557516666160609065535
  70. Li J., Huang J., Yang J.T., et al. Perioperative intravenous lidocaine for postoperative pain in patients undergoing breast surgery: a meta-analysis with trial sequential analysis of randomized controlled trials. Frontiers in Oncology. 2023;13:1101582. https://doi.org/10.3389/fonc.2023.1101582
  71. Xia M., Wei Q., Zhang Q., et al. Effect of intravenous lidocaine on chronic postoperative pain in patients undergoing breast cancer surgery: a prospective, double-blind, randomized, placebo-controlled clinical trial. Annals of Translational Medicine. 2022;10(14):803. https://doi.org/10.21037/atm-22-3522
  72. Vasiliev Ya.I., Marova N.G., Karelov A.E., et al. Systemic administration of lidocaine in the prevention of chronic pain. A.I. Saltanov Journal of Intensive Care. 2019;(2):92–97. (In Russ.) doi: 10.21320/1818-474X-2019-2-92-97
  73. Wei Q., Xia M., Zhang Q., et al. Effect of intravenous lidocaine infusion on perioperative cellular immunity and the quality of postoperative recovery in breast cancer patients: a randomized controlled trial. Gland Surgery. 2022;11(3):599–610. https://doi.org/10.21037/gs-22-134
  74. Sholin I.Yu., Avetisyan V.A., Ezugbaya B.S., et al. The use of lidocaine infusion for analgesia and prevention of intestinal paresis after major abdominal surgery. Regional Anesthesia and Acute Pain Management. 2018;12(2):107–112. (In Russ.) doi: 10.18821/1993-6508-2018-12-2-107-112
  75. Kulishova T.V., Kharchenko S.S. Dynamics of pain, anxiety, depression, and mobility in patients in the early postoperative period after total knee arthroplasty with comprehensive rehabilitation including local air cryotherapy. Journal of Physiotherapy and Balneology. 2024;30(4):49–53. (In Russ.) doi: 10.37279/2413-0478-2024-30-49-53
  76. Muaddi H., Lillie E., Silva S., et al. The effect of cryotherapy application on postoperative pain: a systematic review and meta-analysis. Annals of Surgery. 2023;277(2):e257–e265. doi: 10.1097/SLA.0000000000004987
  77. Bushkovskaya O.V., Morozova M.S. Physiotherapeutic treatment in the rehabilitation of patients after surgical interventions. Scientific and Practical Journal of the Federal Medical and Biological Agency. 2024;1(9). (In Russ.) doi: 10.56547/22263071_2024_1_9
  78. Koleva I.B., Yoshinov B.R., Asenova T.A., et al. Physical Analgesia: Methods, Mechanisms and Algorithms for Post-Operative Pain. Topics in Postoperative Pain. IntechOpen; 2023. doi: 10.5772/intechopen.111590
  79. Leegwater N.C., Nolte P.A., de Korte N., et al. The efficacy of continuous-flow cryo and cyclic compression therapy after hip fracture surgery on postoperative pain: design of a prospective, open-label, parallel, multicenter, randomized controlled, clinical trial. BMC Musculoskeletal Disorders. 2016;17:153. https://doi.org/10.1186/s12891-016-1000-4
  80. Buldan Ö., Arslan S., Güngör H.R., et al. Compressive Cold Application Effect on Pain Level in Patients Undergoing Total Knee Arthroplasty. Pain Management Nursing. 2025. doi: 10.1016/j.pmn.2025.06.005
  81. Garcia C., Karri J., Zacharias N.A., et al. Use of Cryotherapy for Managing Chronic Pain: An Evidence-Based Narrative. Pain and Therapy. 2021;10(1):81–100. doi: 10.1007/s40122-020-00225-w
  82. White P.F., Elvir Lazo O.L., Galeas L., et al. Use of Electroanalgesia and Laser Therapies as Alternatives to Opioids for Acute and Chronic Pain Management. F1000Research. 2017;6:2161. doi: 10.12688/f1000research.12324.1
  83. Ilfeld B.M., Grant S.A. Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation for Postoperative Analgesia: Could Neurostimulation Replace Continuous Peripheral Nerve Blocks? Regional Anesthesia and Pain Medicine. 2016;41(6):720–722. doi: 10.1097/AAP.0000000000000481
  84. Ghai B., Jafra A., Bhatia N., et al. Opioid-Sparing Strategies for Perioperative Pain Management Other Than Regional Anaesthesia: A Narrative Review. Journal of Anaesthesiology Clinical Pharmacology. 2022;38(1):3–10. doi: 10.4103/joacp.JOACP_362_19
  85. Weinrib A.Z., Azam M.A., Birnie K.A., et al. The Psychology of Chronic Post-Surgical Pain: New Frontiers in Risk Factor Identification, Prevention and Management. British Journal of Pain. 2017;11(4):169–177. doi: 10.1177/2049463717720636
  86. Perissinotti D.M.N., Portnoi A.G. Psychobehavioral and Psychosocial Aspects of Neuropathic Pain Patients. Revista Dor. 2016;17(Suppl 1):79–84. doi: 10.5935/1806-0013.20160055
  87. Özden F. The Effectiveness of Physical Exercise After Lumbar Fusion Surgery: A Systematic Review and Meta-Analysis. World Neurosurgery. 2022;163:e396–e412. doi: 10.1016/j.wneu.2022.03.143
  88. Ovechkin A.M. Chronic Postoperative Pain – The Scale of the Problem and Methods of Prevention. Russian Journal of Pain. 2016;(1):3–13.
  89. Manworren R.C. Multimodal Pain Management and the Future of a Personalized Medicine Approach to Pain. AORN Journal. 2015;101(3):307–318. doi: 10.1016/j.aorn.2014.12.009
  90. Admiraal M., Hermanides J., Meinsma S.L., et al. Current Multidisciplinary Approaches to Preventing Chronic Postoperative Pain. British Journal of Anaesthesia. 2021;127(3):331–335. doi: 10.1016/j.bja.2021.04.018

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ ФС 77 - 55827 от 30.10.2013 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ЭЛ № ФС 77 - 80651 от 15.03.2021 г.