Mechanisms of development of postoperative pain syndrome in gynecological patients

Abstract

   Introduction. Despite all the advances in anesthesiology, postoperative pain syndrome remains a serious problem. The lowest satisfaction with postoperative pain relief was found among gynecological patients. For adequate anesthesia and relief of postoperative pain syndrome in gynecological patients, a clear understanding of the features of pain development is necessary.   The purpose of the study: identification of mechanisms of development of postoperative pain syndrome in gynecological patients.   Materials and methods. The search and analysis of literature sources in the databases Scholar Google, Cyberleninka, PubMed, by keywords: physiology of pain, postoperative pain in gynecology, pain syndrome after uterine surgery. Criteria for the inclusion of articles: compliance with the subject of the review and the relevance of the data. The search depth was 33 years. The review includes 59 literary sources.   Results. The development of pain syndrome is influenced by pathophysiological mechanisms, such as: the formation of hyperalgesia zones, changes in estrogen levels, damage to nerve fibers and genetic factors. To assess the level of pain, specialized scales are used, such as YOURS, CRH, DN4 scale. Psychological factors have a great influence on the formation of postoperative pain. Namely, the level of anxiety and depression, the level of catastrophization of pain, coping strategies used, psychological stability.   Conclusion. Postoperative pain syndrome in gynecological patients is associated not only with the physiological mechanisms of pain development, but also with psychoemotional factors. A multidisciplinary approach is needed to alleviate pain in gynecological patients, including not only adequate multimodal anesthesia and analgesia in the perioperative period, but also collaboration with clinical psychologists, psychotherapists, to evaluate and possible selection of psycho-social therapy.