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Pain relief after surgical procedures continues to be a major medical challenge. The alleviation of pain is given a high priority by the medical profession and health authorities, who recognise that improvements in perioperative analgesia are not only desirable for humanitarian reasons, but essential for reducing postoperative morbidity and mortality [1], [2]. The guidelines for acute pain management established by the Agency for Health Care Policy and Research highlight the fact that appropriate pain management in postoperative patients contributes to earlier mobilisation, shorter hospital stay and lower costs. Pain relief per se does not significantly improve the postoperative outcome, with the exception of patient satisfaction and pulmonary complications. Postoperative morbidity and the length of hospital stay are dependent on many factors, including preoperative information, quality of analgesia and existing programs for postoperative care and rehabilitation, including orders for mobilisation, oral nutrition and discharge criteria [3]. In recent years, the techniques for pain management in patients undergoing surgery have substantially improved. The choice of analgesic and the route and technique of administration can be tailored to individual need to optimise pain control and to avoid postoperative discomfort and suffering. However, although there is no reason why a patient should not receive appropriate analgesia, recent surveys have revealed that the incidence of moderate or even severe postoperative pain may be as high as 30—70% [4], [5]. |
