Post-surgical Pain Management Guideline

There is a new guideline released by The American Pain Society that addresses practices to improve pain management postoperative. They complied this guideline from reviews of more than 6500 scientific abstracts and clinical studies and is based on that there is often inadequate pain relief leading to larger, prolonged negative outcomes. The panel that wrote the guideline includes 23 members and incorporate anesthesia, pain management, nursing, and surgery specialties. There are 32 recommendations that are rated based on the quality of evidence as strong, moderate, or weak. There are four recommendations graded as strong. The first recommendation is that there should be wider use of a variety of analgesic medications and techniques. Multimodal anesthesia that specifically target different mechanisms of actions in the nervous systems have shown better pain relief than single medications using one technique. The second recommendation is to use acetaminophen and/or NSAIDs as part of the multimodal management post-surgery. The third recommendation is for clinicians to consider peripheral, regional anesthetic techniques at the surgical site. The fourth recommendation is for patients at risk for cardiac and pulmonary complications or prolonged intestinal distress that spinal analgesia is appropriate in major thoracic and abdominal procedures. They authors of the guideline state that the intended audience of their guideline is all clinicians who manage pain after surgery. How does the pharmacist fit into the target audience, and how could they use these guidelines within their field of practice?

J Pain. 2016;17(2):131-157

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