Clinical update - Post-Operative Pain
This article in the Lancet gives a brief and didactic overview of pain control in the postoperative (post-op) period. The authors note that poorly controlled and persistent pain after surgery does occur, and can result in a chronic pain state. It may also slow healing and increase the risk of complications.
They discuss appropriate methods of pain control following minor, intermediate, and major surgery.
After minor surgery, oral analgesia is normally sufficient, and they suggest paracetamol, NSAID, oxycodone, or tramadol as suitable agents.
Patients undergoing more extensive surgery may require parenteral analgesia, and more potent drugs including opioids, and they discuss the moat appropriate use of these.
They suggest that improved postoperative pain control can be helped by the use of simple multimodal regimens, and present a series of steps that could be used.
Lancet 2007; 369: 810-2 (link to full text, available to subscribers only).