Although scientific interest in the field of pain research is unremitting and the understanding of acute pain mechanisms has eminently advanced, it is evident that clinical practice of postoperative pain management still has major deficits. Indeed, the use of regional analgesia via a catheter, e.g. epidural analgesia (EDA), or patient controlled intravenous analgesia (PCIA) has become very popular. These methods require special equipment, adequate nursing skills and professional expertise as well as the establishment of clinical procedures and an appropriate logistic setup. However, the majority of patients are not managed by EDA or PCIA and cannot be ignored due to lack of knowledge of the proper use of basic analgesic treatment. Therefore, it makes sense to establish a standardized step-concept of postoperative pain management with regular quality control integrated into a multimodal perioperative rehabilitation program.

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