TY - CHAP M1 - Book, Section TI - Chapter 6. Mechanisms of Pain in Thoracic Surgery A1 - Boyette-Davis, Jessica A. A1 - Dougherty, Patrick M. A2 - Barbeito, Atilio A2 - Shaw, Andrew D. A2 - Grichnik, Katherine PY - 2012 T2 - Thoracic Anesthesia AB - Acute pain can be produced from trauma sustained during surgery. This injury results in activation of the nociceptive system, including activation of primary afferent nerve fibers in the periphery, excitation of dorsal horn neurons in the spinal cord, and recruitment of key brain areas. It will further lead to the release of multiple inflammatory mediators, which then potentiate pain.Persistent activation of the nociceptive system can lead to chronic pain. If nerves are damaged during surgery, this chronic pain can present in the form of neuropathy. In both instances, the chronic pain seems to be predominately centrally, as opposed to peripherally, mediated.Analgesic interventions are generally effective for acute postoperative pain. However, for patients who develop chronic post-thoracotomy pain, pain relief is less easily achieved and may be best accomplished best by preemptive analgesia. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=56783012 ER -