Reconceptualizing Acute Pain Management in the 21st Century

• Published in: Advances in anesthesia Vol. 41; no. 1; pp. 87 - 110
• Main Authors: Macres, Stephen, Aldwinckle, Robin J., Saldahna, Usha, Pritzlaff, Scott G., Jung, Michael, Santos, Josh, Kotova, Mariya, Bishop, Robert
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2023
• Subjects: Accidents, Traffic; Acute Pain - diagnosis; Acute Pain - therapy; Acute pain management of the opioid-dependent patient; Acute pain team organization; Acute perioperative pain management; Anesthesia, Conduction; Biased opioid ligand; Cryo-neurolysis and acute pain; Humans; Opioid use disorder; Pain Management; Peripheral nerve stimulation and acute pain; Transcutaneous Electric Nerve Stimulation; Transitional pain service; Acute perioperative pain management; Acute pain team organization; Acute pain management of the opioid-dependent patient; Peripheral nerve stimulation and acute pain; Biased opioid ligand; Cryo-neurolysis and acute pain; Transitional pain service; Opioid use disorder
• ISSN: 0737-6146; 1878-0415; 1878-0415
• DOI: 10.1016/j.aan.2023.06.006

Acute pain can have many etiologies that include surgical procedures, trauma (motor vehicle accident), musculoskeletal injuries (rib fracture) and, burns among others. Valuable components of a multimodal approach to acute pain management include both opioid and non-opioid medications, procedure specific regional anesthesia techniques (peripheral nerve blocks and neuraxial approaches), and interventional approaches (eg, peripheral nerve stimulation and cryo-neurolysis). Overall, successful acute perioperative pain management requires a multimodal, multidisciplinary approach that involves a coordinated effort between the surgical team, the anesthesia team, nursing, and pharmacy staff using Enhanced Recovery After Surgery (ERAS) protocols.