Optimizing postoperative pain management.

Abstract

Successful pain management requires knowing the type of surgical procedure that has been performed as well as patient characteristics that may influence the choice of analgesic. The risk of morbidity is increased in patients with certain underlying conditions such as unstable angina if they do not receive adequate postoperative analgesia. Frequent assessment of pain severity using techniques such as visual analog scales can help optimize pain control. Nonsteroidal anti-inflammatory agents provide good analgesia after most minor surgical procedures and can decrease the amount of opioid analgesics needed after more extensive procedures. Intravenous and epidurally administered opioids are useful; however, better analgesia may be achieved when local anesthetics are administered by infiltration, peripheral nerve block or continuous epidural infusion. The use of two or more analgesic techniques together produces better pain relief than a single medication or administration route. A team approach can lessen the amount of postoperative pain. Family physicians should aggressively treat postoperative pain and actively support hospital postoperative pain treatment programs.