[Nonpharmacological interventions in perioperative pain management]

Nonpharmacological interventions can substantially improve the effectiveness of perioperative pain management. Positive, realistic information and goal setting, together with the deliberate use of communication strategies and placebo effects, can positively influence the experience of pain. Maladaptive cognition and an unnecessary focus on pain can intensify pain perception. Physiotherapy, transcutaneous electrical nerve stimulation (TENS) and acupuncture can be used as adjunctive treatment for selected indications. Music, quiet, appropriate lighting, a pleasant environment and personal belongings are easily implemented environmental factors with potential benefits. Nonpharmacological interventions are not a substitute for established postoperative pharmacological analgesia; however, as low-risk, patient-centered components they should form an integral part of multimodal treatment strategies. Clear responsibilities, appropriate training, interprofessional coordination and realistic patient selection are prerequisites for successful implementation. This article provides a practical overview of the targeted use of these techniques and strategies.