Chronic Pain Clinical Trial
Official title:
ALICE-Regional Anesthesia in Italy: Complications and Outcomes
Regional anesthesia techniques, with administration of local anesthetics for neuraxial or
peripheral route are now playing a central role in modern anesthesia and in particular in
the control of postoperative pain. There are many review and meta-analyzes suggesting that a
good pain control, and specifically loco regional analgesia, may improve the outcome of
patients undergoing surgery.
The control of acute post-operative pain is not the only challenge to be paid by
anesthesiologists, because there is still much to be understood in relation to persistent
post-surgical pain (PPP), and about the degree of influence that regional anesthesia plays
in complete long-term functional recovery of patients.
From the pathophysiological perspective there is not a precise definition of the mechanisms
and risk factors that determine the onset of the persistent pain after surgery, but, more in
general, it seems to be related to a malfunction of the mechanism of secondary hyperalgesia.
Regional anesthesia could play a key role, as the main determinant of chronic pain is acute
post-operative pain. The techniques of regional anesthesia exert a powerful block at the
peripheral level, potentially preventing the progression of central pain and the persistence
of stimuli that can reach the central nervous system. In addition, during surgery, these
techniques can reduce the metabolic alterations and the triggering mechanisms of local and
systemic pro-inflammatory mediators' release.
Few perspective studies exist about the influence of regional anesthesia on long-term
outcome and persistent pain after surgery.
The objective of the investigators study is to assess in a prospective fashion the role of
regional anesthesia/analgesia technique in preventing (or not) persistence pain occurrence
after surgical interventions which are mostly associated to pain persistence, and understand
if regional anesthesia provides advantages in other post-surgical outcomes.
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