Postoperative pain management

Recent evidence has documented the deleterious physiologic effects of pain and the beneficial results of effective postoperative analgesia. As outlined in this article, a three-step approach is recommended depending on the severity of pain. The three-step approach utilizes a combination of NSAIDs, oral or intravenous opioids. In addition to selecting a particular opioid to use, the practitioner must also consider the route of administration and the mode of administration. All three choices may significantly impact on the efficacy of analgesia. While we continue to use primarily intravenous opioids to treat moderate and severe pain in the hospital setting, future formulations and developments may allow for the increased use of non-parenteral routes.