Can We Predict Postoperative Pain Prior to Patients’ Undergoing Surgery?

Abstract

Copyright: © 2012 Carvalho B. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Perioperative pain is the most common concern for patients undergoing surgery, and many patients experience unpleasant side effects related to pain medications [1,2]. Despite increased emphasis on pain management and creation of new standards for controlling postoperative pain, many patients continue to experience moderate to severe pain after surgery [2]. If we can identify preoperative factors which reliably predict patients at risk of developing severe postoperative pain, we may be able to significantly improve postoperative pain management by: 1) creating individualized rather than standardized treatment plans, 2) properly allocating resources, and 3) intervening early to improve patients’ postoperative care. Current standardized pain management protocols may lead to undertreatment of some patients and overtreatment (increased side effects from analgesics) of others, whereas individual plans specify stratified or targeted treatments. For example, practitioners could utilize larger drug doses (e.g., 200 mcg versus 100 mcg intrathecal morphine) and might add adjunct medications (e.g., ketamine, clonidine) with narrow therapeutic indexes and adverse side-effect profiles only in patients “at risk” of severe, postoperative pain.