Management of Chronic Post-Surgical Pain (CPSP): The Challenging Role of Nurses in Transitioning Pain Care from Acute to Chronic Pain

Abstract

Introduction: Chronic postsurgical pain is a significant complication with lasting effects on patients. Poor management of this condition can negatively affect patients' quality of life and rehabilitation processes. This academic article aims to explain the pathophysiological mechanisms and risk factors that contribute to the transition from acute to chronic postsurgical pain throughout all phases of care. Additionally, it highlights the importance of nurses in conducting risk screening and implementing integrated pain management strategies to reduce the incidence of chronic postsurgical pain.

Methods: A literature review has identified that the mechanisms underlying chronic postsurgical pain are complex and multifactorial. Risk factors span various phases: preoperative (including psychosocial aspects and negative attitudes toward pain), intraoperative (encompassing the type of surgery, nerve injury, and methods of analgesic administration), and postoperative (notably the severity of pain within the first 72 hours). Effective management should begin with an assessment of the risk for developing chronic postsurgical pain, incorporate multimodal pain management strategies, and provide comprehensive holistic care across all dimensions.

Results: Nurses play a crucial and demanding role in screening high-risk patients, identifying neuropathic pain warning signs during the transition phase, managing pain, coordinating care, educating patients for self-management, and maintaining continuous follow-up.  These interventions help reduce the incidence of chronic postsurgical pain and support sustainable recovery and quality of life for patients.

Conclusion: Effective management of chronic postsurgical pain requires interdisciplinary collaboration and continuous care, beginning in the preoperative phase and extending through home rehabilitation. Nurses play a crucial role in this process by systematically implementing proactive nursing strategies that reduce the incidence of chronic postsurgical pain and consistently improve patients' quality of life.