New techniques in postoperative analgesia. Including patient-controlled intravenous administration

New and more efficient techniques of postoperative pain management have been recently introduced. Patient-controlled intravenous (and perhaps subcutaneous) administration of analgesics is an improvement over traditional intramuscular injection. Its efficacy, safety, and high acceptance by patients, surgeons, and nurses make this technique increasingly popular for routine management of postoperative pain. Epidural or intrathecal administration of narcotic agents, although more efficient in controlling pain than intravenous infusion, should probably be reserved for indications such as major thoracic and abdominal procedures. Spinal administration requires more routine surveillance and, when inadequately managed, has the potential for serious side effects and complications. Clinical investigations currently in progress are aimed at finding more successful and safer methods of postoperative pain control. The best methods will likely involve a multifaceted therapeutic approach rather than the simple effect of one "magic bullet."