Abstract
The pre-emptive analgesic strategies aimed at reducing chronic post-surgical pain, and CPIP, have shown inconsistent results. Regional anesthetic techniques continue to hold out the tantalizing prospect of being the universal panacea. However, definitive evidence is not strong enough to make this the de facto approach in all patients. Peri-operative risk factors for CPIP have been enumerated and validated in small series. Model predictive ability remains too weak to provide consistent for reliable use none the less open repair of recurrent hernias in young females with high pre-operative pain scores seems to confer the highest risk [6]. Intra-operative approaches have appeared to have limited influence on CPIP. Importantly, early high post-operative pain has consistently been identified as risk factor.