Improving the management of post-operative acute pain: priorities for change

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...Poor management in the case of post-operative acute pain can contribute to medical complications such as pneumonia, deep vein thrombosis, infection, chronic pain and depression7^,8. It is also one of the three most common medical causes of delayed discharge after ambulatory surgery9. In addition to the significant personal suffering and social burden that result, considerable financial expense is incurred, both directly in extra healthcare costs and indirectly as a result of absenteeism, lost production and welfare payments. All post-operative acute pain should therefore be prevented if possible or, if not, accurately diagnosed and then treated promptly and effectively to improve patient comfort, avoid complications, prevent the development of chronic pain, and reduce the economic burden on society10. However, despite the numerous guidelines on managing acute pain produced over the past two decades11–14, the proven benefits of the ‘pain-free hospital’ initiative15 and the many effective analgesics now available, surveys suggest that for many patients there has been little improvement over this period16–18.....