[Postoperative pain therapy in inpatient treatment]

Pain therapy is a central medical task and a legal duty. Not the anaesthetist but the pain-causing surgeon is responsible for therapy of pain. Pain as a negative sensation is subjective and individual. Postoperative pain is an essential aspect of the topic "pain in surgery". Therapy starts with the awareness of the problem. Effective pain therapy requires clinical competence and application of available therapeutic options. Initial steps of successful pain treatment include: an informative dialogue with the patient, conveying of confidence, and skillful choice of diagnostic and/or therapeutic options. Application of drugs presupposes detailed knowledge of their specific effects. For convincing therapeutic results, one has to analyse different causes of pain. Acute surgical pain is classified and treated according to a three-step scheme: intense pain with strong opioids, intermediate pain with weaker opioids or non-opioids, and slight pain with non-steroidal anti-inflammatory drugs. Opioids are used with caution in abdominal surgery because of their negative effects (obstipation), the same is the case with Novalgin in trauma patients because of its effect on temperature and leukopenia. Patient-controlled analgesia with appropriate devices means further progress for suitable patients. Effective pain therapy within the framework of successful surgery is feasible and influences patients' comfort and possibly even their morbidity and mortality.