Basics of surgical pain management
1. Big picture
Surgical pain management is the prevention, assessment, and treatment of pain before, during, and after surgery. It is not only about patient comfort. Good pain control improves:
- breathing and coughing after abdominal/thoracic surgery,
- early mobilization,
- sleep and recovery,
- wound healing indirectly through reduced stress response,
- prevention of chronic postsurgical pain,
- prevention of complications such as atelectasis, pneumonia, venous thromboembolism, delirium, and prolonged hospital stay.
The key exam principle:
Surgical pain management = assess pain properly
→ exclude dangerous surgical causes of pain
→ use multimodal analgesia
→ titrate to effect
→ monitor adverse effects
→ reassess frequently
Do not simply increase opioids in a patient with unexpected severe postoperative pain. First ask: is there a surgical complication?
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