Postoperative Pain Management

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Abstract
In the past decade there has been a dramatic increase in ambulatory surgical procedures. The number of surgical procedures conducted on an outpatient basis exceeds the number of inpatient procedures. An important factor in the successful management of ambulatory surgery is the adequate control of postoperative pain. Pain is the most common surgery-related reason for unexpected hospital admissions. Pain is also a determining factor in the decision as to when patients are ready for discharge from the ambulatory center [1]. Furthermore, uncontrolled pain may delay discharge by precipitating nausea and vomiting. Struggling, crying, and restlessness can result in hematoma formation and thereby delay wound healing. Adequate pain control leads to decreased manipulation of the surgical site and thus reduces swelling, hematoma formation, and infection [1]. Finally, patients' perception of the quality of their overall ambulatory surgical experience is greatly enhanced by effective pain control. In the ambulatory setting, analgesic technique should be effective, intrinsically safe with minimal side effects, easily managed away from the hospital or surgical center, and cost-effective. Pain management for ambulatory surgery includes intraoperative use of rapid-acting intravenous (IV) opioid analgesics to decrease the anesthetic requirement and provide effective analgesia in the early postoperative period, as well as the use of oral analgesics for controlling pain after discharge. Regional and local anesthetic techniques may be used for analgesia during the perioperative period.

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