Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Section 1 General
- Chapter 1 Anesthesia management of the surgical patient
- Chapter 2 Specialized nutrition support in the surgical patient
- Chapter 3 Preoperative testing
- Chapter 4 Medication safety for surgical patients
- Chapter 5 Informed consent and decision-making capacity
- Chapter 6 Ethical considerations in the surgical patient
- Chapter 7 Perioperative pain management
- Chapter 8 The medical consult
- Section 2 Cardiology
- Section 3 Hypertension
- Section 4 Pulmonary
- Section 5 Gastroenterology
- Section 6 Hematology
- Section 7 Infectious disease
- Section 8 Renal disease
- Section 9 Endocrinology
- Section 10 Rheumatology
- Section 11 Neurology
- Section 12 Surgery in the Elderly
- Section 13 Obesity
- Section 14 Transplantation
- Section 15 Psychiatric Disorders
- Section 16 Peripartum Patients
- Part 2 Surgical Procedures and their Complications
- Index
- References
Chapter 7 - Perioperative pain management
from Section 1 - General
Published online by Cambridge University Press: 05 September 2013
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Section 1 General
- Chapter 1 Anesthesia management of the surgical patient
- Chapter 2 Specialized nutrition support in the surgical patient
- Chapter 3 Preoperative testing
- Chapter 4 Medication safety for surgical patients
- Chapter 5 Informed consent and decision-making capacity
- Chapter 6 Ethical considerations in the surgical patient
- Chapter 7 Perioperative pain management
- Chapter 8 The medical consult
- Section 2 Cardiology
- Section 3 Hypertension
- Section 4 Pulmonary
- Section 5 Gastroenterology
- Section 6 Hematology
- Section 7 Infectious disease
- Section 8 Renal disease
- Section 9 Endocrinology
- Section 10 Rheumatology
- Section 11 Neurology
- Section 12 Surgery in the Elderly
- Section 13 Obesity
- Section 14 Transplantation
- Section 15 Psychiatric Disorders
- Section 16 Peripartum Patients
- Part 2 Surgical Procedures and their Complications
- Index
- References
Summary
Overview: Benefits of postoperative pain control
Acute pain, highlighted by Marks and Sachar's 1973 landmark article on the undertreatment of pain in inpatients, has been discussed in the medical literature for many years [1]. Despite the advances made, the attention given, the development of national guidelines on the evaluation and treatment of acute pain, and adoption of pain as the “fifth vital sign,” postoperative pain is still undertreated [2,3]. A 2003 survey of postoperative patients in the USA showed that 82% of patients reported postoperative pain lasting until 2 weeks after discharge; 39% of these described the pain as severe [3].
Both over- and undertreatment of pain can result in negative consequences in the outpatient perioperative setting [4,5]. Untreated pain results in stimulation of the stress response and increased sympathetic activity which can then lead to increased myocardial demand and systemic hypercoagulability [3,5]. Inactivity, inability to take deep breaths and other activities limited by pain may increase the chance of developing postoperative ileus, deep vein thrombosis and atelectasis [3]. Undertreated pain is the most common reason for delayed discharge home following ambulatory surgery and it is often a reason for unanticipated hospital admission [5,6].
- Type
- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 61 - 69Publisher: Cambridge University PressPrint publication year: 2013