Acute postoperative pain management.

E ffective postoperative pain control is an essential component of the care of the surgical patient. Inadequate pain control, apart from being inhumane, may result in increased morbidity or mortality (1, 2). Evidence suggests that surgery suppresses the immune system and that this suppression is proportionate to the invasiveness of the surgery (3, 4). Good analgesia can reduce this deleterious effect. Data available indicate that afferent neural blockade with local anesthetics is the most effective analgesic technique. Next in order of effectiveness are high-dose opioids, epidural opioids and clonidine, patientcontrolled opioid therapy, and nonsteroidal anti-inflammatory agents (5). The advantages of effective postoperative pain management include patient comfort and therefore satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, a reduced risk of deep vein thrombosis, faster recovery with less likelihood of the development of neuropathic pain, and reduced cost of care. The failure to provide good postoperative analgesia is multifactorial. Insufficient education, fear of complications associated with analgesic drugs, poor pain assessment, and inadequate staffing are among its causes.