Postoperative pain management--back to basics

Butscher describes a common-sense approach to pain management which is simple, safe and effective. A wide variety of national and international organization devoted to the management of pain have universally adopted these simple measures. Current guidelines advocate both regular dosing and rescue analgesia. These guidelines were produced by an army of international experts and have been available for a decade. Although the information is widely published, it is rarely adopted in clinical practice. It is any wonder that leaders in the field of pain management ask: "Is education enough?" "Will guidelines make a difference?" They continue to lament the "tragedy of needless pain" and in despair they have called for "national initiatives on pain." Bonica stated so elegantly, "for nearly 30 yr I have studied the reasons for inadequate management of postoperative pain, and they remain the same...inadequate or improper application of available information and therapies is certainly the most important reason for inadequate analgesia does not require futuristic high tech solutions. In fact, as the economic crunch continues we may find that we cannot afford some of these new, improved and more expensive techniques. If we can provide safe and effective analgesia for only pennies a day, this option cannot be ignored. The new way may be the old way.