Chronic post surgical pain management - Primary Care Masterclass Podcast

In this podcast, Dr. Kodsi, an adult medicine physician with expertise in palliative and pain medicine, addresses the challenging topic of chronic post-surgical pain management. He begins with an illustrative case of a 62-year-old retired teacher named Margaret who, despite a successful mastectomy and a cancer-free diagnosis, continues to experience significant pain affecting her quality of life. Dr. Kodsi emphasizes that chronic post-surgical pain is a prevalent issue, impacting approximately half of patients undergoing high-risk procedures, such as mastectomies. He highlights the importance of recognizing and addressing these pain issues as they often manifest in a general practice setting rather than in surgical or hospital environments.Dr. Kodsi sheds light on his journey as a pain specialist, underlining the crucial role that general practitioners play in managing chronic pain. He insists on early collaboration between general practitioners, anesthetists, and pain specialists to prevent pain from becoming a long-term burden. Recognizing that the road to recovery can be disrupted by chronic pain, he introduces various interventions and strategies aimed at reducing the incidence of chronic pain in surgical patients.A key focus of the lecture is the discussion of the factors that contribute to chronic post-surgical pain. Dr. Kodsi explains biological and psychological factors, emphasizing the role of demographic variables such as age and pre-existing psychological issues, including catastrophic beliefs about pain. Preoperative opioid use also emerges as a significant negative factor, complicating recovery and raising the risk of chronic pain outcomes. He encourages healthcare professionals to implement multimodal pain management strategies, focusing on preemptive analgesia to potentially mitigate hypersensitivity and its consequences.As the lecture progresses, Dr. Kodsi reviews historical studies, including seminal surveys identifying the high prevalence of phantom limb pain and chronic pain following surgical interventions. He discusses the evolution of understanding chronic post-surgical pain and the classification criteria established over the years, highlighting the need for further understanding of pain mechanisms such as central sensitization and neuroplastic changes.Delving into practical interventions, Dr. Kodsi outlines the objectives and mechanisms of various pain management strategies, including the use of diagnostic nerve blocks and the role of regional anesthesia. He emphasizes the concept of preventive analgesia, advocating for the administration of analgesics before surgical procedures to minimize the likelihood of developing chronic pain. The discussion includes a review of different analgesic agents and techniques, such as the use of gabapentinoids and corticosteroids, while addressing their respective risks and benefits during the preoperative and postoperative periods.Moreover, he discusses the importance of assessing patients for neuropathic pain and the significance of opioid stewardship in managing postoperative pain. Dr. Kodsi highlights the necessity of transitioning patients off opioids whenever feasible and exploring alternative medications that could lower the chances of developing chronic post-surgical pain. He underscores the combination of pharmacological and non-pharmacological approaches as crucial to fostering better recovery outcomes for patients.Chronic post surgical pain management Dr Anthony KodsiIn conclusion, Dr. Kodsi emphasizes that effective management of chronic post-surgical pain begins with a recognition of the various risk factors involved, prompt preoperative planning, and collaborative pain management strategies. He calls upon general practitioners to actively participate in the prevention of chronic pain by understanding these dynamics and implementing immediate, evidence-based solutions to improve patient trajectories.-------------------------------------------------------------------------------To help other GPs discover this podcast please rate and leave a review on Apple Podcasts here https://podcasts.apple.com/us/podcast/armchair-medical-conference-podcasts/id1861409097 or Spotify here https://open.spotify.com/show/7s6bKrFxgj1AjP71pALZ0TAccess thousands of premium conference podcasts and 'full video' podcasts including synchronised PowerPoint slides at https://www.armchairmedical.tv/podcastsGeneral Practitioners: Earn your full year's worth of CPD including Educational Activities, Reviewing Performance and Measuring Outcomes CPD Hours. Discover more at https://www.armchairmedical.tv/podcastsPress play. You’re at the conference.In every episode of ArmchairMedical Conference Podcasts, we bring Australia’s leading medical conference education straight to your headphones.No travel.No full days away from clinic.No disruption to your life.Each episode features real conference lectures, captured live and carefully curated into short, practical, evidence-based podcasts designed for busy general practitioners.Whether you’re commuting, exercising, or moving through the gaps of your day, this is conference-quality learning that fits real GP life.If you value staying at the leading edge of medicine, but don’t have the time to attend every conference, this is the smart way to do it.🎧 Press play. You’re at the conference.About ArmchairMedical Conference PodcastsArmchairMedical Conference Podcasts transform Australia’s best medical conferences into on-demand audio education for GPs. Learn from leading clinicians and experts, anytime and anywhere, in a format designed to work with - not against - your day.Enjoying the episode?⭐ Rate this episode➕ Follow the podcast💬 Share it with a colleague who’d value conference learning without the time awayDisclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.Visit https://www.armchairmedical.tv/podcasts for more information.