[Current developments in postoperative pain management]

The aim of the postoperative pain therapy is besides the amelioration of the patients well-being, also lessening of unwanted vegetative reactions and avoidance of the need for excessive care situations. There are numerous ways of therapy and medication at our disposal for this purpose. The first line of drugs are the analgesically most active opiates; they can be combined with antiphlogistics and antipyretics, in order to decrease the specific opiate-induced side effects. Besides the parenteral way the epidural application is being used. Local anesthetics are a valuable alternative to the systemic pain relief therapy and can postoperatively be combined with opiates. By this combination the total dose and the relevant side effects can be reduced. During the last years patient-controlled analgesia was the modern way and the nearest approach to ideal dosing. In comparison to the conventional way, its therapeutic success was described as convincing, even overwhelming. Difficulties or deficiencies in the postoperative pain therapy are mostly caused by lack of time and insufficient knowledge and experience of the personnel, on the other hand also by limited technical possibilities of monitoring the patient. A possible solution may be the setting-up of a special service for the treatment of postoperative pain.