Postoperative pain management and outcome after surgery

Postoperative pain management aims not only to decrease pain intensity but also to increase patient comfort and to improve postoperative outcome. Better pain control is achieved through a multimodal combination of regional analgesic techniques and systemic administration of analgesic agents. To guarantee uneventful follow-up and unnecessary prolongation of hospital stay, it is important to avoid side-effects of analgesic agents, especially those of opioids which are dose-related, by decreasing opioid demand through combination with non-opioid agents. Epidural analgesia not only has the advantage of providing potent and effective analgesia but also of hastening recovery of bowel function and facilitating physiotherapy and rehabilitation. Unfortunately, a reduction in postoperative morbidity and mortality by epidural analgesia has not actually been demonstrated. Inclusion of postoperative pain treatment in a multimodal approach of patient rehabilitation may improve recovery and shorten hospital stay. Effective treatment of postoperative pain is also likely to prevent chronic pain syndrome after surgery, but further studies are needed to support this hypothesis.

Key words: postoperative analgesia, epidural analgesia, postoperative morbidity, opioids, non-opioid analgesics