Postoperative Pain Management: Clinical Practice Guidelines

Abstract

OVER THE PAST 2 decades, there has been an increased emphasis on the need for effective management of acute pain. The focus on pain management was sharpened when the Joint Commission on Accreditation of Healthcare Organizations integrated the requirement for pain assessment and management into their standards in 2000. 1 Berry P.H. Dahl J.L. The new JCAHO pain standards: Implications for pain management nurses. Pain Manag Nurs. 2000; 1: 3-12 Abstract Full Text Full Text PDF PubMed Scopus (161) Google Scholar Acute postoperative pain, however, continues to be inadequately controlled. Among patients who have had surgical procedures, 80% experience postoperative pain and 75% or more of them report pain that is at a moderate, severe, or extreme level. 2 Gan T.J. Habib A.S. Miller T.E. White W. Apfelbaum J.L. Incidence, patient satisfaction, and perceptions of post-surgical pain: Results from a US national survey. Curr Med Res Opin. 2014; 30: 149-160 Crossref PubMed Scopus (454) Google Scholar Inadequately treated acute pain is associated with the risk for the development of persistent postsurgical pain. 3 Clarke H. Bonin R.P. Orser B.A. Englesakis M. Wijeysundera D.N. Katz J. The prevention of chronic postsurgical pain using gabapentin and pregabalin: A combined systematic review and meta-analysis. Anesth Analg. 2012; 115: 428-442 Crossref PubMed Scopus (298) Google Scholar , 4 Page M.G. Katz J. Romero Escobar E.M. et al. Distinguishing problematic from nonproblematic postsurgical pain: A pain trajectory analysis after total knee arthroplasty. Pain. 2015; 156: 460-468 Crossref PubMed Scopus (68) Google Scholar Poor pain control has significant physiological consequences that can ultimately result in impaired recovery, decreased function, and reduced quality of life. 2 Gan T.J. Habib A.S. Miller T.E. White W. Apfelbaum J.L. Incidence, patient satisfaction, and perceptions of post-surgical pain: Results from a US national survey. Curr Med Res Opin. 2014; 30: 149-160 Crossref PubMed Scopus (454) Google Scholar , 5 Argoff C.E. Recent management advances in acute postoperative pain. Pain Pract. 2014; 14: 477-487 PubMed Google Scholar Maureen F. Cooney, DNP, FNP-BC, is a Nurse Practitioner, Pain Management, Westchester Medical Center, Valhalla, NY