Acute postoperative pain management

Abstract

Background Acute postoperative pain is common. Nearly 20 per cent of patients experience severe pain in the first 24 h after surgery, a figure that has remained largely unchanged in the past 30 years. This review aims to present key considerations for postoperative pain management. Methods A narrative review of postoperative pain strategies was undertaken. Searches of the Cochrane Library, PubMed and Google Scholar databases were performed using the terms postoperative care, psychological factor, pain management, acute pain service, analgesia, acute pain and pain assessment. Results Information on service provision, preoperative planning, pain assessment, and pharmacological and non‐pharmacological strategies relevant to acute postoperative pain management in adults is presented, with a focus on enhanced recovery after surgery pathways. Conclusion Adequate perioperative pain management is integral to patient care and outcomes. Each of the biological, psychological and social dimensions of the pain experience should be considered and understood in order to provide optimum pain management in the postoperative setting.

Postoperative Pain Management

“…Pain intensity scales are often used and include the Numeric Rating Scale (0 to 10 scale where 0 represents no pain and 10 represents worst imaginable pain), Verbal Rating Scale (comprises a list of adjectives used to denote increasing pain intensities), and the Visual Analog Scale (a 10-cm line anchored by verbal descriptors of "no pain" and "worst imaginable pain" and the patient is asked to mark a line to indicate pain intensity). 6 There is insufficient evidence to recommend a specific pain assessment tool over another in the postoperative period, although the numerical rating scale (NRS) is the most commonly used, with satisfactory analgesia commonly occurring with ≤3 out of 10, and an estimated minimally important difference of 2 points. 20 Additionally, the Brief Pain Inventory (BPI) is a simple and easy tool for assessing pain and is useful in chronic or cancer pain; however, it is not clinically feasible to assess acute surgical pain due to pain dynamics and high frequency for assessments by nurses.…”

“…While postoperative pain has traditionally been the primary responsibility of surgeons, successful management of postoperative pain requires a multidisciplinary approach that involves anesthesiologists, internists, perioperative physicians, and family physicians. 6 An understanding of postoperative pain and commonly used interventions are required for effective management of patients undergoing surgery. This article aims to provide a basic overview of the principles, approaches, and strategies to manage acute postoperative pain.…”

Implications of Regional Anaesthesia for Favourable Postoperative Outcomes

“…The list of advantages of providing good quality postoperative analgesia is endless. The few most important advantages are patent comfort, early mobilization, hastened wound healing process, reduced risk of thromboembolic phenomenon like deep vein thrombosis, early recovery of gut function, lesser duration of hospital stay and thus overall lesser cost of treatment [3]. Poorly managed postoperative pain has been found responsible for development of chronic postsurgical pain after a few months [4].…”

Oral Pregabalin in Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Among them, pain management is an important aspect and requires anesthesiologists to actively participate in this important stage of postoperative recovery patients to improve the quality of postoperative recovery. Effective postoperative pain management can greatly improve the quality of patients, shorten the length of hospital stay, accelerate clinical turnover, and enable the rational allocation of clinical resources [3,4]. Currently, multimodal analgesia is mostly used for postoperative pain treatment.…”