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Psychological Aspects of Chronic Postsurgical Pain

Chronic postsurgical pain（CPSP）is strongly correlated with a psychological component, with pre-operative depression and anxiety being well known risk factors of CPSP. Some animal studies have reported that psychological stress not only leads to depression and anxiety but also activates spinal microglial cells to cause spinal neuroinflammation and central sensitization. These changes may lead to the exacerbation of postoperative acute pain and delayed recovery. Perioperative cognitive behavioral therapy and patient education may help prevent the development of CPSP. Perioperative antide-pressants may also help provide pain relief for patients with CPSP, but their prophylactic effects re-main unclear, so multi-directional studies will be needed to better understand the mechanisms underlying CPSP.