Advances in regional anaesthesia and analgesia.

Abstract

Despite intense research in the last three decades and exciting new revelations in the physiology and pharmacology of nociception, it remains a common misconception among anaesthesiologists that acute postoperative pain is a transient condition involving physiological nociceptive stimulation, with a variable effective component, that differs markedly in its pathophysiological basis from chronic pain syndromes. However, it is known that clinical pain differs from physiological pain and that acute and chronic pain share common mechanisms. Acute postoperative pain still remains a major problem after surgery. The significant improvements that have been observed over the last years have resulted mostly from better organization and management and more intensive application of long-established drugs and techniques rather than, to date, the synthesis of new “magic drugs”. The introduction of acute pain teams with the use of patient-controlled analgesia and epidural infusions of either local anaesthetic or a mixture of local anaesthetic and opioid on surgical wards represent major advances in improving patient well being compared to previous decades.KeywordsTotal Knee ArthroplastyLocal AnaestheticEpidural AnalgesiaChronic Pain SyndromeShoulder SurgeryThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.