Postoperative Analgesia

Jae-Hyon Bahk

doi:10.5124/jkma.2007.50.12.1090

Journal List > J Korean Med Assoc > v.50(12) > 1041849

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Bahk: Postoperative Analgesia

Focused Issue of This Month

Anesthetic Choices in Surgery

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2007; 50(12): 1090-1095.

Published online: 31 December 2007

DOI: https://doi.org/10.5124/jkma.2007.50.12.1090

Postoperative Analgesia

Jae-Hyon Bahk, MD

Department of Anesthesiology, Seoul National University College of Medicine, Korea. bahkjh@plaza.snu.ac.kr

Abstract

Uncontrolled or inadequately controlled postoperative pain may lead to delayed recovery from surgery, pulmonary complications, and restriction of mobility leading to increased risk of thromboembolism. Standardized regimens for pain management can lead to safer and better pain control. Of these regimens, patient-controlled analgesia, a delivery system with which patients self-administer small, predetermined analgesic doses, produced improved pain relief, greater patient satisfaction, less sedation, and fewer postoperative complications. Anesthesiologists have played an important role to make this pain management feasible. The introduction of acute pain services at hospitals prompted improvements in postoperative pain management in addition to the minimization of related complications.

Keywords: Postoperative pain, Standardized analgesic regimen, Patient-controlled analgesia, Acute pain service

Figures and Tables

Figure 1

Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) and Verbal Rating Scale (VRS) (2).

Table 1

Suggested steps to improve postoperative analgesia(6)

Adult doses given; adjust for weight and age in children. NSAIDs=non-steroidal anti-inflammatory drugs, COX-2=cyclo-oxygenase 2. Special populations: chronic pain patients and those on chronic opioid or opioid antagonist therapy (eg, oxycodone, morphine, methadone, naltrexone, and transdermal buprenorphine and fentanyl) require particularly individualized attention that includes preoperative planning of appropriate analgesic regimen and close supervision from acute pain service (or equivalent).

Table 2

Comparison between patient-controlled analgesia (PCA) and nurse-controlled analgesia (NCA) (12)

= indicates equal; > indicates superior; < indicates inferior

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