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How to Manage Pain After Surgery

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The International Association for the Study of Pain (IASP) has named 2017 the Global Year Against Pain After Surgery. Anyone who is undergoing surgery wants the process to be as smooth and painless as possible, and the IASP has dedicated this year towards promoting better pain management after surgery, with efforts targeting both healthcare professionals and patients.

The IASP has published 14 Fact Sheets that cover important and helpful tips about pain after surgery.  These pain resources cover everything from guidance for patients on how to be involved in care and support for making decisions to recommendations for health care professionals on how best to approach the many aspects of pain and pain management.

Listed below are the 14 fact sheets from the IASP:

  1. What the Public Should Know About Pain After Surgery

Includes information on past and current approaches to pain after surgery, and guidance for patients and families about questions to ask and what to discuss with health care professionals following surgery.

  1. What Health-Care Professionals Should Know About Pain After Surgery

Reviews how today’s evidence-guided approach to surgery can reduce or avoid certain adverse effects of undertreated acute postoperative pain and lists potential factors contributing to variability of pain after surgery.

  1. Pathophysiology of Acute Postoperative Pain

Includes a discussion regarding important components of pain pathophysiology (functional changes associated with pain).

  1. Chronic Postsurgical Pain: Definition, Impact, and Prevention

Summarizes chronic postsurgical pain (CPSP) and mentions that the prediction of CPSP using certain clinical factors might in theory allow preemptive targeting of individuals at risk.  This is important because roughly one or two of 10 surgical patients will have CPSP - which is influenced by type of surgical procedure.

  1. Management of Postsurgical Pain in Adults: Pharmacotherapy and Regional Anesthesia

Discusses how management of postsurgical pain has evolved to include a multimodal approach that includes non-opioids and at times regional anesthesia.

  1. Behavioral Techniques including Hypnosis for Pain After Surgery

Multiple trials have shown that behavioral modalities are effective in decreasing acute postsurgical pain and other symptoms such as anxiety, indicating that people can learn to achieve certain states that will help with pain management.  Some behavioral modalities including patient education, cognitive behavioral techniques, modification of attention, relaxation and controlled breathing exercises are listed in this factsheet.

  1. Management of Postsurgical Pain in Children

Untreated acute pain in children and adolescents can result in chronic pain. This fact sheet covers parent and professional roles, local/regional techniques, medications, psychological and physical approaches to pain management for children after surgery.

  1. Management of Postsurgical Pain in Older Adults

Older adults are less able to recruit the body’s natural pathways to decrease pain in some situations. This factsheet reviews the older adult surgical patient evaluation, postoperative pain assessment, nonpharmacological and pharmacological treatment considerations, and importance of communication with both patients and primary health-care professionals about the postsurgical treatment plan. 

  1. Management of Postsurgical Pain in Patients Treated Preoperatively with Opioids

Increasing numbers of patients come to surgery already receiving opioids.  This factsheet discusses overarching principles of pain management in opioid-tolerant patients following surgery.

  1. Management of Pain Related to Surgery and Procedures in Patients with Known or Suspected Cancer

The number of new cancer cases and patients who undergo surgery continues to increase. This factsheet reviews preoperative assessment, intraoperative management, and postoperative management recommendations for patients with known or suspected cancer.

  1. Pain Management in Critical Care 

Chronic pain after an intensive care unit stay is now considered to be an important outcome to measure, as pain may interfere with functional capacity recovery and affect quality of life.  This factsheet outlines surgical ICU acute and chronic pain assessment and management information.

  1. Acupuncture for Acute Pain and Nausea After Surgery

This factsheet outlines how acupuncture may work for postoperative pain and outlines some clinical evidence and benefits for acupuncture in postoperative pain.

  1. Management of Patients First Presenting with Chronic Pain After Surgery

Chronic postsurgical pain involves biological, psychological and social factors. This factsheet reviews recommendations for clinical assessment and management of patients presenting with chronic pain after surgery.

  1. Using Outcomes to Improve Care: Real-Time, Short-Term, and Long-Term

The quality of pain management can be assessed by evaluating structures, processes and outcomes of pain after surgery.  This factsheet discusses quality care, and outcomes of importance related to the management of pain caused by surgery such as patient-reported outcomes, clinical outcomes and health economic outcomes.

To learn more about pain management, visit the IASP website here or download IWP’s Patient Pain Resource for Injured Workers which contains information on alternative therapy options and helpful tips for caregivers.

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