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35 - Posttrauma Chronic Pain

Published online by Cambridge University Press:  18 January 2010

By
David Ryan  and
Kutaibba Tabbaa
Edited by
Charles E. Smith
David Ryan
Affiliation:
Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
Kutaibba Tabbaa
Affiliation:
Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
Charles E. Smith
Affiliation:
Case Western Reserve University, Ohio
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Summary

Objectives

  1. Discuss the pathophysiology and treatment of complex regional pain syndrome (CPRS).

  2. Evaluate and manage posttraumatic headache, whiplash, and phantom limb pain.

  3. Review the incidence, classification, and management of post-spinal cord injury pain.

We must all die. But that I can save him from days of torture that is what I feel as my great and ever new privilege. Pain is a more terrible Lord of mankind than even death itself.

Albert Schweitzer

INTRODUCTION

Though advances in trauma care have led to improved survival for victims of major trauma, these patients are frequently living with increased disability and chronic pain. A prospective cohort study of 201 trauma surgical patients found that only one third did not develop chronic pain at seven months, while one third developed significantly debilitating chronic pain at the same interval [1]. Likewise, studies of chronic pain populations have shown that a significant percentage of these patients have a history of trauma or surgery. Clearly, chronic pain is a common and potentially devastating consequence of trauma. In this chapter we will review chronic pain syndromes in the trauma patient after considering the historical and current clinical approach to the chronic pain patient.

A BRIEF HISTORY OF PAIN

Pain has been viewed throughout history as a punishment for sins and has been associated with mystical beliefs for thousands of years.

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Chapter
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Trauma Anesthesia , pp. 544 - 568
Publisher: Cambridge University Press
Print publication year: 2008

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  • Posttrauma Chronic Pain
    • By David Ryan, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, Kutaibba Tabbaa, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.038
Available formats
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Posttrauma Chronic Pain
    • By David Ryan, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, Kutaibba Tabbaa, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.038
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Posttrauma Chronic Pain
    • By David Ryan, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, Kutaibba Tabbaa, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.038
Available formats
×