Research progress on neurobiological mechanisms of chronic postoperative pain

Postoperative pain is a common complication caused by surgical trauma. Epidemiological studies indicate that the incidence of moderate to severe acute postoperative pain ranges from 41% to 85%, with approximately 10% to 50% of patients potentially progressing to chronic pain. This progression not only significantly impairs patients' quality of life, but also imposes substantial medical and socioeconomic burdens. The mechanisms underlying chronic postoperative pain are highly complex, involving the activation and sensitization of peripheral nociceptors, central sensitization of spinal dorsal horn neurons, and maladaptive alterations in higher-order cortical neural circuits. Additionally, local and systemic inflammatory responses induced by surgical injury, and psychosocial factors, such as anxiety, depression, and sleep disturbances, have all been shown to play critical roles in the transition from acute to chronic postoperative pain. This article systematically reviews the latest advances in risk factors, animal models, pathophysiological mechanisms, and therapeutic strategies of postoperative pain, with particular emphasis on key processes and potential intervention targets involved in the transition from acute to chronic pain, aiming to offer a more solid theoretical foundation and evidence-based guidance for clinical practice.