Current interventions and approaches to postoperative pain management

Abstract

Some degree of pain accompanies all surgical procedures. Current evidence informs us that patients will experience significant physiological and psychological effects if this pain is not adequately treated. These effects can cause serious harm, delay recovery from surgery, and in some cases lead to persistent post-surgical chronic pain. This article briefly discusses the importance of assessing patients preoperatively and highlights how some patients will have risk factors which may lead them to experience severe postoperative pain. Approaches to postoperative pain control are focused on ways to address the inter-patient differences in response to pain and treatments and avoid periods of ineffective pain relief. A review of the commonly used analgesics, paracetamol, non-steroidal anti-inflammatory drugs, opioids and local anaesthetics, and methods of administration, is included. The final section provides a short review of emerging trends in acute pain therapy and the implications for improving patient care.

The use of phenylbutazone in the horse

“…, 2008; Huang et al. , 2008; Layzell & Layzell, 2008). Despite the use of PBZ postoperatively on a routine basis, similar studies in the total management of postoperative pain using NSAID combined with the opioids are lacking in the equine.…”

“…The use of NSAID in combination with more potent opioids for high-intensity pain and the weaker opioids for moderate-to low-intensity pain has been the topic of numerous publications discussing emerging trends in pain management (Schug et al, 2007;Fischer et al, 2008;Huang et al, 2008;Layzell & Layzell, 2008). Despite the use of PBZ postoperatively on a routine basis, similar studies in the total management of postoperative pain using NSAID combined with the opioids are lacking in the equine.…”

Pathophysiology of Pain: Implications for Perioperative Nursing

“…This type of pain is usually associated with significant observable tissue pathology and routinely resolves with healing. However, acute pain that is inadequately treated can lead to long‐term changes in the nervous system, chronic pain, and psychological distress 6,7 . Acute pain also involves biological functions that protect against further injury.…”

Delivering Quality Pain Management: The Challenge for Nurses

“…Acute pain is a complex condition causing physiological and psychological distress. Pain contributes to the surgical stress response, with implications for the neural‐immune‐endocrine systems 1 . Even brief intervals of acute pain can induce long‐term changes in the nervous system, including structural remodeling and sensitization of the nervous system, chronic pain, and long‐lasting psychological distress.Recent evidence suggests that providing effective pain management in the early postoperative period may lead to clinically important outcomes with respect to early and long‐term recovery 1,2 .…”

“…Pain contributes to the surgical stress response, with implications for the neural‐immune‐endocrine systems 1 . Even brief intervals of acute pain can induce long‐term changes in the nervous system, including structural remodeling and sensitization of the nervous system, chronic pain, and long‐lasting psychological distress.Recent evidence suggests that providing effective pain management in the early postoperative period may lead to clinically important outcomes with respect to early and long‐term recovery 1,2 . Unfortunately, despite heightened awareness of and clinical advances in pain management, evidence continues to suggest that pain is undertreated in the postoperative setting, raising concerns related to this provision of quality patient care 3‐5 …”