Post-Operative Pain Management: A Modern Approach

Abstract

Post-operative pain may influence the content of postoperative stress response. New approaches focus on optimizing pain management by using preemptive, preventive, and multimodal analgesia. This includes continuous wound perfusion for 3–5 days postoperatively and adding omega-6 fatty acid derivatives to local anesthetics as well as lidocaine and several alpha-2 agonists to various analgesics. Dose fractionation strengthens the intense analgesic component of opioids. The application of ethylene requires elevated endogenous ligands in the brain tissues and the intimate contact of exogenous ligands with specific anti-nociceptive receptors. Recognition of acute on chronic pain facilitates tailoring of post-operative pain management to the individual patient. Neuro-immune mechanisms pave the way for a ban on immunosuppressive opioid-sparing agents in major surgery. (Cooney & Quinlan-Colwell, 2020)