Background:
Proper pain relief is a major concern of patients worldwide. Preoperatively, one of the most
common questions asked by patients pertains to the amount of pain they will experience after
surgery how long it will last and how good will it be controlled. Pain concerns the surgical
team as well, because of its correlation with clinical outcomes and patients' satisfaction
rate. Studies have shown that negative clinical outcome with regard to pain control includes
decreases in vital capacity and alveolar ventilation, pneumonia, tachycardia, hypertension,
myocardial ischemia, transition into chronic pain, poor wound healing, and psychological
sequelae .
Pain has been found to be one of the three most common medical causes of delayed/aborted
discharge after ambulatory surgery, the other two being drowsiness and postoperative
nausea/vomiting. Despite progress that has been made with regard to postoperative pain
control, and the development of new standards for pain control, many patients continue to
experience intense pain after surgery .
Recent advances in the understanding of the particularities of central sensitization indicate
that it plays an important role in post surgical and post traumatic pain and therefore should
be avoided