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Postoperatif Pain


and analgesia was needed only for pain at rest.• Thirty years ago. • Postoperative hospital stay was longer. patients were not expected to get out of bed. patients were encouraged to rest for days. . even weeks. after surgery. feeding was delayed.

• Since then. whereby normal physiologic function is restored as rapidly as possible. the concept of accelerated recovery. • Optimal pain control is an integral component of accelerated recovery. has replaced the idea that rest is best. and paradoxically. postoperative pain management is now based on multimodal analgesia and opioid sparing. although opioids are the most effective analgesics available. .

• Multimodal analgesia also makes sense because acute pain is an integrated process mediated by a range of transmitters and neural pathways. . so it seems rational to target analgesics to a number of different processes.

PRINCIPLES OF POSTOPERATIVE PAIN MANAGEMENT 1. Psychologic Preparation 2. Assesing Pain 3. Preemptive Analgesia .

• They should be told about the choices for postoperative pain management. • Patients should also be familiar with the chosen pain assessment method and the need to assess pain on a regular basis. • They should be aware that some degree of postoperative pain is inevitable.Psychologic Preparation • Patients need reassurance. If they have never had surgery before. . they should be told what to expect.

. • The method used does not need to be elaborate. it is preferable to use rudimentary scales such as the 0 to 10 verbal analog scale (VSA). in fact.Assesing Pain • Assessments of pain severity. analgesic side effects. and markers of recovery are the tools by which analgesic regimens can be tailored to need.