Post-surgical pain: evolving drug treatments and challenges

Effective postoperative pain is a significant challenge for clinicians. Suboptimal pain management can lead to delayed recovery and increased risk of chronic pain. Multimodal analgesia strategies are increasingly adopted but variably implemented.

This review evaluates current and emerging pharmacologic agents for postoperative pain, from established drugs like acetaminophen, NSAIDs, and ketamine to off label and adjunct agents like vitamin C and duloxetine. It also critically appraises novel formulations of local anesthetics, opioids, and emerging agents with promising potential. The review highlights clinical implementation barriers including costs, provider familiarity, and real-world evidence.

Despite an ever-expanding pharmacologic arsenal, postoperative pain control continues to be hindered by systemic, clinical, and institutional barriers. Although several new agents show promising results in reducing opioid consumption and improving recovery, their widespread adoption is limited by high costs and lack of robust long-term data. Bridging the gap between innovation and clinical practice requires coordinated efforts in research, education, and policy development.