Perioperative analgesia: ever-changing technology and pharmacology

Best Pract Res Clin Anaesthesiol. 2014 Mar;28(1):3-14. doi: 10.1016/j.bpa.2014.03.002. Epub 2014 Mar 15.

Abstract

Our understanding of pain and its long-term implications have dramatically changed with the advent of advancements in molecular mechanisms involved in acute or postoperative pain and chronic pain. This better understanding has led to multiple pharmacologic advancements to better treat pain with minimal side effects. Currently, we are still struggling to find the right balance between all of the different modalities that we have at our leisure. In order to best take care of postoperative pain, we are improving patient satisfaction, decreasing hospital stays, and decreasing the development of long-term pain and its related complications. However, despite using a multimodal approach that includes newer technologies, we still have a long way to go before we can guarantee a pain-free postoperative course or a comfortable end for a terminally ill patient. These arms of anesthesiology are ever changing. Anesthesiologists have taken a leadership role in perioperative pain management and clinical research designed for the improvement of pain.

Keywords: adjuvant analgesics; ketamine; multimodal analgesia; opioids; patient-controlled analgesia; patient-controlled regional anesthesia; regional anesthesia.

MeSH terms

  • Analgesia / adverse effects
  • Analgesia / methods*
  • Anesthesiology / methods
  • Drug Design
  • Humans
  • Length of Stay
  • Pain, Postoperative / prevention & control*
  • Patient Satisfaction
  • Perioperative Care / methods*