Improving postoperative pain management: what are the unresolved issues?

Paul F White, Henrik Kehlet

    233 Citations (Scopus)

    Abstract

    Despite the tremendous progress that has been made in our understanding of the pathophysiologic basis of acute pain, there remains a need for clinicians to implement evidencebased procedure-specific multimodal analgesic protocols, which are modified to meet the needs of individual patients to enhance the quality of postoperative pain management. Importantly, there is a critical need for collaborations between the various heathcare providers involved in perioperative patient care (e.g., anesthesiologists, surgeons, nurses, and physiotherapists) to integrate improved perioperative pain management with the recently described fast-track recovery paradigms.14,15 This type of combined approach is well documented to improve the quality of the recovery process and reduce the hospital stay and postoperative morbidity, leading to a shorter period of convalescence after surgery. Rather than simply performing more meta-analysis and systematic reviews of the pain management literature,12 clinical investigators need to return to the hard work of performing prospective, randomized clinical trials on a procedure-specific basis, evaluating the use of different analgesic combinations as part of multimodal analgesic treatment regimens in the postoperative period.

    Original languageEnglish
    JournalAnesthesiology News
    Volume112
    Issue number1
    Pages (from-to)220-5
    Number of pages6
    ISSN0747-4679
    DOIs
    Publication statusPublished - 1 Jan 2010

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