Preventing Transition from Acute to Chronic Pain Use of Analgesics with Different Pharmacology

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An intense nociceptive impulse transmitted to the dorsal horn of the spinal cord, always results in the release of excitatory neurotransmitters and peptides. Aside from activating interneuronal cells, they also stimulate the cells of the spinotha-lamic tract resulting in a prolonged sensitization and augmentation of all incoming further nociceptive impulses. Such an effect can outlast the original impulse [7], a phenomenon called central hypersensitization or "wind-up" [91, 92]. Clinically this is related to hyperalgesia in the damaged area accompanied by dysesthesia in the surrounded skin with prolonged pain [6, 69].

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