Anesthesiology and Clinical Science Research

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Commentary - Anesthesiology and Clinical Science Research (2023) Volume 7, Issue 4

Effective pain management post-anesthesia: A critical review

Aadhya Alisah*

Department of Anesthesiology, University of Sydney, New South Wales, Sydney, Australia

Corresponding Author:
Aadhya Alisah
Department of Anesthesiology,
University of Sydney,

Received: 08-Jun-2023, Manuscript No. AAACSR-23-101746; Editor assigned: 12-Jun-2023, AAACSR-23-101746 (PQ); Reviewed: 26-Jun-2023, QC No. AAACSR-23-101746; Revised: 07-Aug-2023, Manuscript No. AAACSR-23-101746 (R); Published: 14-Aug-2023, DOI:10.35841/aaacsr.7.4.151

Citation: Alisah A. Effective pain management post-anesthesia: A critical review. Anaesthesiol Clin Sci Res. 2023;7(4):1-2.

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Post-anesthesia pain management plays a vital role in ensuring the well-being and comfort of patients after surgical procedures. Adequate pain control is essential to facilitate recovery, reduce distress and promote early mobilization [1]. In this review, we will examine the current practices and advancements in pain management techniques after anesthesia.

Multimodal analgesia

The implementation of multimodal analgesia has revolutionized post anesthesia pain management. By combining various pharmacological agents with different mechanisms of action, this approach provides superior pain relief while minimizing opioid consumption and associated side effects [2]. The synergistic effects of non-opioid medications such as acetaminophen, NSAIDs, and local anesthetics have been shown to reduce postoperative pain intensity and improve patient satisfaction. Moreover, multimodal analgesia contributes to a more balanced and individualized pain management plan.

Regional anesthesia techniques

Regional anesthesia techniques, including peripheral nerve blocks and epidural analgesia, have gained popularity due to their ability to provide targeted pain relief. These techniques offer prolonged analgesia, enabling reduced opioid usage and decreased risk of opioid related adverse effects. Furthermore, regional anesthesia can enhance patient outcomes by facilitating early ambulation and reducing the risk of complications such as deep vein thrombosis. Continued advancements in ultrasound-guided techniques have improved the accuracy and safety of regional anesthesia, making it an integral part of post anesthesia pain management protocols.

Patient Controlled Analgesia (PCA)

Patient controlled analgesia has been widely utilized for managing pain after anesthesia. PCA empowers patients to self-administer analgesic medication within predetermined safety limits, allowing them to effectively manage their pain levels [3]. This approach not only improves pain control but also promotes patient satisfaction and reduces the reliance on healthcare providers for pain relief. However, proper patient education and careful monitoring are crucial to prevent potential overdose or underdosing incidents.

Enhanced Recovery after Surgery (ERAS) protocols

ERAS protocols have transformed the perioperative care landscape, including pain management after anesthesia. By employing a multidisciplinary approach and evidence based strategies, ERAS protocols aim to optimize patient recovery and minimize the physiological stress associated with surgery [4]. These protocols incorporate several interventions, such as preoperative counselling, pre-emptive analgesia, intraoperative fluid management, and early mobilization, to enhance pain control and expedite functional recovery. Implementing ERAS protocols can lead to reduced opioid requirements, shorter hospital stays, and improved patient outcomes.

Psychological and non-pharmacological interventions

Complementary non pharmacological interventions and psychological support have emerged as valuable adjuncts to traditional pain management strategies. Techniques like relaxation exercises, distraction therapy, music therapy and cognitive-behavioural interventions can effectively reduce pain perception and enhance the overall analgesic effect. Integrating these interventions into post anesthesia care plans can improve patient comfort and satisfaction while potentially decreasing the need for higher doses of analgesic medications [5].

Acute postoperative pain remains a major problem, resulting in multiple undesirable outcomes if inadequately controlled. Most surgical patients spend their immediate postoperative period in the Post-Anesthesia Care Unit (PACU), where pain management, being unsatisfactory and requiring improvements, affects further recovery. Recent studies on postoperative pain management in the PACU were reviewed for the advances in assessments and treatments. More objective assessments of pain being independent of patients’ participation may be potentially appropriate in the PACU, including photoplethysmography derived parameters, analgesia nociception index, skin conductance, and pupillometry, although further studies are needed to confirm their utilities. Multimodal analgesia with different analgesics and techniques has been widely used. With theoretical basis of preventing central sensitization, preventive analgesia is increasingly common. New opioids are being developed with minimization of adverse effects of traditional opioids. More intravenous nonopioid analgesics and adjuncts (such as dexmedetomidine and dexamethasone) are introduced for their opioid sparing effects [6]. Current evidence suggests that regional analgesic techniques are effective in the reduction of pain and stay in the PACU. Being available alternatives to epidural analgesia, perineural techniques and infiltrative techniques including wound infiltration, transversus abdominis plane block, local infiltration analgesia, and intraperitoneal administration have played a more important role for their effectiveness and safety.


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