Postoperative pain management

Implication for health policy/practice/research/medical education: Due to expertise of anesthesiologists in analgesics pharmacology, epidural and peripheral nerve blockade, they have pioneered in the postoperative pain management. Reading this article is beneficial for physicians, interventional pain managers and who care about pain medicine. The practice of modern anesthesiology has been developed from intraoperative period into perioperative period. Postoperative pain management is one of the most important components of adequate post-surgical patients care. This article wrote with the aim of emphasis on importance and effectiveness of post-operative pain management. Reading this article is beneficial for physicians , interventional pain managers and who care about pain medicine. Unrelieved acute pain after surgery usually elicits pathophysiologic neural alterations, including not only peripheral but also central sensitization which evolves into chronic pain syndromes. The main purpose of perioperative pain control is providing an adequate comfort level and acceptable side effects for patients. Effective postoperative analgesia improves patients' outcome as observed by early ambulation, decrease in side effects , and reduce the incidence of postoperative chronic pain (1-3) Even though postoperative pain management and its implications have gained a significant attention in health care during last three decades, it continues to be a major challenge that still remains disregarded (4, 5). Post-operative analgesia has traditionally been provided by administration of opioid analgesics. However, excessive opioids administration is associated with a variety of sidement of opioid analgesics can provide better postop-erative pain management outcome. The opioid-sparing effects of these compounds may lead to reduced side effects of opioids (6). Nowadays variety of new drugs, analgesic techniques and devices, and preventive approaches are available for anesthesiologists, including patient-controlled analgesia (PCA), multimodal analgesia and pre-emptive analgesia. Besides, one of the most common methods for postoper-ative pain relief is PCA. This device is commonly assumed to imply on-demand intermittent, intravenous administration of opioids under patient control (with or without a continuous background infusion). PCA device is based on the use of a sophisticated microprocessor-controlled infusion pump that delivers a preprogrammed dosage of opioid analgesics when the patient pushes a demand button. Grass presented a more enlightened concept of PCA, noting that using any analgesic drugs under control of patient by any routes could be categorized as PCA, like patient-controlled epidural analgesia (PCEA) and patient-controlled regional analgesia (PCRA) (7). He proposed practical guidelines for the clinical usage of PCA, highlighted the complications and their management. To optimize the management of acute …