Anesthesiology and Clinical Science Research

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Mini Review - Anesthesiology and Clinical Science Research (2025) Volume 9, Issue 2

Postoperative pain: Multimodal, opioid-sparing strategies

Ahmed El-Sharif*

Department of Surgical Sciences, Cairo Medical University, Cairo, Egypt

*Corresponding Author:
Ahmed El-Sharif
Department of Surgical Sciences
Cairo Medical University, Cairo, Egypt.
E-mail: a.elsharif@cmu.eg

Received : 02-Jun-2025, Manuscript No. aaacsr-216; Editor assigned : 04-Jun-2025, PreQC No. aaacsr-216(PQ); Reviewed : 24-Jun-2025, QC No aaacsr-216; Revised : 03-Jul-2025, Manuscript No. aaacsr-216(R); Published : 14-Jul-2025 , DOI : 10.35841/aaacsr-9.2.216

Citation: El-Sharif A. Postoperative pain: Multimodal, opioid-sparing strategies. aaacsr. 2025;09(02):216.

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Introduction

Multimodal analgesia, combining different pain relief mechanisms, is a cornerstone for effective postoperative pain management. This approach helps reduce opioid consumption and minimize side effects while improving patient recovery and satisfaction. The review emphasizes combining pharmacological agents like NSAIDs, acetaminophen, regional anesthesia, and nerve blocks, alongside non-pharmacological strategies [1].

Accurate assessment of postoperative pain is fundamental to effective management. This systematic review explores various pain assessment tools, highlighting their validity, reliability, and clinical applicability. It emphasizes the importance of using appropriate tools for different patient populations, including non-verbal patients, to ensure comprehensive and individualized pain care, ultimately improving outcomes [2].

Regional anesthesia plays a critical role in enhancing postoperative pain control and accelerating recovery. This update highlights advancements in various regional blocks, their efficacy in reducing opioid requirements, and improving functional outcomes across different surgical specialties. It emphasizes tailored approaches, considering patient-specific factors and surgical procedures for optimal pain relief [3].

The opioid crisis necessitates implementing effective opioid-sparing strategies in postoperative pain management. This review discusses various approaches, including multimodal analgesia, regional anesthesia, and non-pharmacological interventions, all aimed at reducing reliance on opioids while maintaining adequate pain control. The goal is to improve patient safety, minimize opioid-related side effects, and prevent long-term opioid dependence [4].

Beyond medications, non-pharmacological interventions are crucial for holistic postoperative pain management. This review explores techniques such as acupuncture, transcutaneous electrical nerve stimulation (TENS), cognitive behavioral therapy, aromatherapy, and music therapy. Integrating these methods can significantly enhance patient comfort, reduce anxiety, and complement traditional pain relief strategies, contributing to better recovery experiences [5].

Enhanced Recovery After Surgery (ERAS) protocols are transforming postoperative care, with pain management as a cornerstone. This article updates ERAS guidelines, focusing on optimized pain strategies for colorectal surgery. It emphasizes proactive multimodal analgesia, regional techniques, and minimized opioid use to facilitate early mobilization, reduce complications, and shorten hospital stays, aligning with the broader ERAS philosophy [6].

The transition from acute to chronic postoperative pain is a significant clinical challenge. This article delves into the underlying mechanisms driving this transition, including genetic predispositions, psychosocial factors, and persistent inflammatory responses. Understanding these pathways is vital for developing targeted preventive strategies and early interventions to mitigate the risk of long-term pain and improve patient quality of life after surgery [7].

Managing postoperative pain in children presents unique challenges due to developmental differences in pain perception and expression. This review discusses the current understanding of pediatric postoperative pain, emphasizing age-appropriate assessment tools, multimodal analgesic strategies, and the importance of parental involvement. Effective pain control in children is crucial for their immediate comfort and long-term psychological well-being [8].

Moving towards personalized medicine, postoperative pain management is increasingly tailored to individual patient needs. This article advocates for considering patient-specific factors such as genetics, comorbidities, psychological status, and prior opioid exposure when designing pain regimens. This individualized approach aims to optimize pain relief, minimize adverse effects, and improve overall patient satisfaction and functional recovery [9].

Emerging evidence explores the potential role of cannabinoids in postoperative pain management, especially for chronic and opioid-refractory pain. This review synthesizes current research on their analgesic properties, mechanisms of action, and safety profile. While promising, more robust clinical trials are needed to define their precise role, optimal dosing, and long-term efficacy as part of a comprehensive pain strategy [10].

 

Conclusion

Postoperative pain management is a complex but crucial aspect of patient recovery, evolving towards comprehensive, patient-centered approaches. Key strategies include multimodal analgesia, which combines various pharmacological and non-pharmacological methods to optimize pain relief while significantly reducing reliance on opioids [1, 4]. Regional anesthesia techniques are increasingly utilized for their efficacy in controlling pain, lowering opioid consumption, and improving functional outcomes across different surgical specialties [3]. Beyond medication, non-pharmacological interventions like acupuncture, TENS, and cognitive behavioral therapy are integral to enhancing patient comfort and complementing traditional pain relief strategies [5]. Effective pain management relies heavily on accurate assessment, requiring valid and reliable tools suitable for diverse patient populations, including non-verbal individuals [2]. The ongoing opioid crisis underscores the importance of opioid-sparing strategies, focusing on safety, minimizing side effects, and preventing long-term dependence [4]. Furthermore, advancements in Enhanced Recovery After Surgery (ERAS) protocols integrate optimized pain strategies, particularly for procedures like colorectal surgery, to facilitate early mobilization and reduce hospital stays [6]. Specific challenges in pain management include the unique considerations for pediatric patients, necessitating age-appropriate assessment and multimodal approaches [8], and understanding the mechanisms that drive the transition from acute to chronic postoperative pain to enable targeted prevention [7]. The field is also moving towards personalized medicine, tailoring pain regimens based on individual patient factors such as genetics, comorbidities, and psychological status to optimize outcomes and satisfaction [9]. Emerging research is exploring novel treatments, such as the potential role of cannabinoids for chronic and opioid-refractory pain, although more robust clinical trials are still needed to define their precise application [10].

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