Chronic Pain and Fascial Blocks

Chronic postsurgical pain (CPSP) is defined as chronic pain that develops or increases in intensity after a surgical procedure and persists beyond the healing process, at least 3 months after the surgery. The presence of acute pain represents the fundamental requirement for the chronicity of pain. Chemical and mechanical stimulation of peripheral nociceptors causes peripheral sensitization. All these changes cause “central sensitization,” which is a state of reduced thresholds to stimulations associated with the intensification of the response of neuronal activity in the dorsal horn, with the possible development of chronic pain. There are several risk factors that predispose to the development of CPSP, including the type of anesthesia. Regional anesthesia may reduce the risk of persistent CPSP. In fact, blocking nociception during any part of the perioperative experience may prevent persistent pain after surgery, and thanks to studies on the anatomy and pathophysiology of the fascial system, fascia blocks have an important role in the treatment of this pathology.