A new evidence-based clinical practice guideline focusing on management of post-surgical pain has been released this week by the American Pain Society. The guideline, appearing in The Journal of Pain, offers 32 recommendations to optimize pain management after surgery, the current lack of which increases the risk for chronic post-surgical pain, as well as physical impairment and mood disorders. According to lead author Roger Chou, MD, head of the Oregon Evidence-based Practice Center, the target audience for the new recommendations is all clinicians who manage pain resulting from surgery.
The central recommendation in the guideline is for clinicians to engage multimodal anesthesia that are targeted to different mechanisms of action in the central and peripheral nervous system, Chou stated. Evidence from randomized trials, he said, supports the conclusion that simultaneous use of medication combinations are associated with reduced opioid consumption and provide superior pain relief, compared to administration of a single medication by one technique. The guideline also advocates the incorporation of non-pharmacological therapies such as cognitive behavioral therapy and transcutaneous elective nerve stimulation. Read more about the new guidelines here. The article abstract may be read here.