Current approaches to acute postoperative pain management after major abdominal surgery: a narrative review and future directions

Pirie, K; Traer, E; Finniss, D; Myles, PS; Riedel, B

Author(s): Pirie, K; Traer, E; Finniss, D; Myles, PS; Riedel, B;
Details: Publication Year 2022-09,Volume 129,Issue #3,Page 378-393
Journal Title: British Journal of Anaesthesia
Publication Type: Review
Abstract: Poorly controlled postoperative pain is associated with increased morbidity, negatively affects quality of life and functional recovery, and is a risk factor for persistent pain and longer-term opioid use. Up to 10% of opioid-naive patients have persistent opioid use after many types of surgeries. Opioid-related side-effects and the opioid abuse epidemic emphasise the need for alternative, opioid-minimising, multimodal analgesic strategies, including neuraxial (epidural/intrathecal) techniques, truncal nerve blocks, and lidocaine infusions. The preference for minimally invasive surgical techniques has changed anaesthetic and analgesic requirements in abdominal surgery compared with open laparotomy, leading to a decline in popularity of epidural anaesthesia and an increasing interest in intrathecal morphine and truncal nerve blocks. Limited research exists on patient quality of recovery using specific analgesic techniques after intra-abdominal surgery. Poorly controlled postoperative pain after major abdominal surgery should be a research priority as it affects patient-centred short-term and long-term outcomes (including quality of life scores, return to function measurements, disability-free survival) and has broad community health and economic implications.
Keywords: Analgesics; *Analgesics, Opioid/therapeutic use; Humans; Lidocaine/adverse effects; Pain, Postoperative/drug therapy/prevention & control; *Quality of Life; abdominal surgery; laparoscopic; lidocaine; neuraxial analgesia; opioids; outcomes; postoperative pain; regional analgesia
Department(s): Anaesthetics
PubMed ID: 35803751
Publisher's Version: https://doi.org/10.1016/j.bja.2022.05.029
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-02-20 06:41:19

Last Modified: 2025-02-20 06:42:28