1Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
2Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
Chronic post-surgical pain (CPSP) is a chronic pain condition that reduces quality of life. The mechanisms of CPSP are complex, and pain management is limited. In particular, perioperative pain management is crucial to ensure long-term pain relief and CPSP prevention. The management and prevention of CPSP involves pharmacological treatment with opioids, acetaminophen, N-methyl-D-aspartate receptor antagonists, anticonvulsants, and local anesthesia. These treatments may be delivered via various routes, but all can provide better postoperative analgesia, with opioid-sparing effects and fewer opioid-related adverse effects, thus, preventing CPSP. Recently, ultrasound-guided peripheral nerve blocks have been widely used for regional anesthesia and postoperative analgesia. A newly lunched continuously released opioid naldebain can provide a long-term perioperative preventive pain inhibition. The present issue of the Taiwan Journal of Pain (TJP), a case report involving the use of ultrasound-guided peripheral nerve block and epidural anesthesia, this combination provided satisfactory anesthesia and postoperative pain relief. Continuous preventive perioperative analgesia is crucial for improving the quality of postoperative pain management, thus, attenuating or even preventing CPSP. This review discusses the role of combination of epidural anesthesia, ultrasound-guided peripheral nerve block plus naldebain in CPSP.
Chronic post-surgical pain,Epidural anaesthesia,Nadebain,Ulrasound-giuded nerve block.