Postoperative Pain Management

ADVANCEMENTS IN POSTOPERATIVE PAIN MANAGEMENT: NAVIGATING CHRONIC PAIN CHALLENGES

“My goal as an interventional pain therapist is to improve the quality of life and mobility of patients, and it’s extremely fulfilling when my interventions can contribute to that,” stated Dr. Johannes Blasl, a distinguished anesthetist and local-regional pain therapist.

 

What is Postoperative pain management

Postoperative pain management constitutes a significant component of anesthesiology, addressing both acute and chronic pain. Chronic pain after surgeries is frequently overlooked despite being a common consequence of tissue injuries and nerve damage during surgical procedures. While pain directly caused by surgery usually diminishes after a few weeks, preventing chronic pain isn’t always feasible. Hence, preoperative identification of risk factors, precise and nerve-preserving surgical techniques, along with an effective pain management plan, are pivotal in minimizing chronic pain occurrences.

Surgeries involving the abdomen or groin vividly demonstrate the diverse nature of pain, ranging from nociceptive to neuropathic. Each pain type has specific origins and necessitates the expertise and anatomical knowledge of seasoned pain therapists. Once identified, targeted treatments can be initiated, such as local-regional pain management, involving ultrasound-guided localization and specific numbing or exposure of the affected nerve.

Another example pertains to major knee procedures like total knee arthroplasty, where around 20% of patients experience burdensome chronic pain even three months or more post-operation. The multitude of causes often renders treatments ineffective. Five to ten percent of patients continue to suffer from severe pain and significantly reduced quality of life many months later. When no other objective causes are identified, nerve injury is often presumed. Blocking the suspected pain-causing nerve through a ‘diagnostic blockade’ followed by ultrasound-guided repeated blocks can alleviate pain. Frequently, this involves a specific nerve on the inner side of the knee, which can be well visualized and specifically numbed under ultrasound.

 

further therapeutic options

In addition to the aforementioned techniques, there are further therapeutic options like local pain patches, physiotherapy, cortisone, or radiofrequency ablation. In some cases, exposing or severing the nerve may be considered as a last resort. Every pain is unique, necessitating careful evaluation, diagnosis, and a tailored treatment plan. Collaborative efforts among different specialties are indispensable in this regard.