Speakers - 2027

Title: Chronic post - Surgical neuropathic pain after laparoscopic cholecystectomy: A case report emphasizing mechanism - Based multimodal management

Abstract

This is a case of a 67-year-old female who developed chronic neuropathic pain four months after laparoscopic cholecystectomy. Extensive gastrointestinal evaluation excluded structural pathology. A Quantitative sensory testing demonstrated hyperalgesia and allodynia localized to incision sites, consistent with neuropathic chronic post-surgical pain. Initial intermittent tramadol use provided only transient relief and posed risk for prolonged opioid exposure. A multimodal, opioid-sparing strategy including gabapentin and transition from escitalopram to duloxetine led to progressive improvement and eventual complete resolution of pain (VAS 0/10), with improvement of mood, sleep, appetite, and functional capacity.

This case report describes the development of chronic neuropathic pain following laparoscopic cholecystectomy and highlights the importance of early multimodal analgesia, psychological risk identification, and mechanism-targeted pharmacotherapy. The case demonstrates successful resolution of chronic post-surgical pain through an opioid-sparing strategy incorporating gabapentin and duloxetine, emphasizing both neurophysiologic and affective components of chronic pain.