RT Book, Section A1 Boyette-Davis, Jessica A. A1 Dougherty, Patrick M. A2 Barbeito, Atilio A2 Shaw, Andrew D. A2 Grichnik, Katherine SR Print(0) ID 56783012 T1 Chapter 6. Mechanisms of Pain in Thoracic Surgery T2 Thoracic Anesthesia YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-162566-1 LK accessanesthesiology.mhmedical.com/content.aspx?aid=56783012 RD 2024/03/28 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.