Balanced anaesthesia 2005: Avoiding the Transition from Acute to Chronic Pain

When general anaesthesia consisted of the administration of a volatile anaesthetic agent according to clinical parameters usually preceded by premedication, was chronic post-operative pain a significant problem? Have we, by working hard to deliver balanced anaesthesia and rapid recovery lost sight of the fundamental importance of abolishing noxious reflexes at the spinal level?We need to identify, ameliorate and manage specific features and risk factors, including the severity of the acute pain experience, for individuals at risk for the development of a chronic pain syndrome. Anaesthetists' actions and the drugs they use have multiple and profound effects to be taken into account, appropriately modified and controlled, combined with excellent postoperative analgesia, particularly for those patients or procedures at high risk to minimise the transition of acute to chronic pain following surgery.Acute nociceptive pain is the risk for the transition to chronic neuropathic pain.