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Pain After Surgery
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"This up-to-date review of basic and clinical research into chronic postsurgical pain presents the current understanding about the cellular changes in the nervous system that lead to the development of chronic pain. It is an updated version of a monograph presented in 2013 at a research meeting.

The primary focus is on understanding the development of chronic pain after surgery and how to prevent it and/or treat it once it happens. In this context, the book covers different aspects of chronic postsurgical pain from bench research to clinical applications. No progress is possible without improving the understanding of this aspect of chronic pain. The book successfully achieves its objectives.

The book targets basic and clinical scientists as well as all physicians who manage chronic pain patients on a regular basis. This is not a textbook of chronic pain, but rather a detailed look at the current understanding of chronic pain using postsurgical pain as an example. The book authors and contributors are renowned in their fields and they have done a great service to the field of pain with this book.

The 24 chapters are grouped into six sections. The first section outlines the role of tissue damage on nociceptive pathways and changes in central pathways in response to tissue nociception. The second reviews changes in ascending and descending pain pathways when nociception is ongoing, producing changes in ion channel and neurotransmitter production and release, as well as changes in supporting cells. Section three covers various basic research techniques that are being used to study and quantify nociception at the spinal and supraspinal level, all in an attempt to better characterize chronic pain pathophysiology. Section four presents the current state of knowledge about the development of chronic pain from an acute pain state, trying to develop models to predict chronic pain. Section five focuses on interventions that can prevent chronification of pain in an acute pain setting that are currently available to surgeons and anesthesiologists. The last section focuses on application of basic scientific knowledge to clinical practice, reviewing different medications, anesthetic techniques, and psychological interventions that can be employed for better outcomes. The chapters are brief, simple, and practical reviews of the topics. The focus is on understanding mechanisms that lead to the persistence of pain. Despite the extensive study of chronic pain, it's obvious that much more needs to be done. Reading this book is a humbling experience, demonstrating as it does the lack of understanding about this problem.

This is a nice book on a common, underappreciated problem that is reaching epidemic proportions. No other pain book dedicates enough time to this condition. By focusing on chronic postsurgical pain, the book sets the stage for better management of this condition by providing a concise understanding of the process."

Weighted Numerical Score: 96 - 4 Stars!
Doodys Publishers' Club, September 2018

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