Recommended Approach to Pain Management After Surgery Not Yet Standard Practice

Many surgical patients are concerned about the level of pain they will experience. In a new study presented at ANESTHESIOLOGY 2011, researchers from Thomas Jefferson University identified that multimodal analgesia, a combination of pain medication and therapeutic measures to improve pain control, is used less than 25 percent of the time prior to surgery.

“The American Society of Anesthesiologists and other medical societies have recommendations that support a multimodal analgesic regimen. Studies show that when multimodal analgesia is used before surgery it can help reduce the amount of pain after surgery,” said lead study author Jaime L. Baratta, M.D.

To assess how extensively medical providers in the U.S., predominately in anesthesiology, use a multimodal approach, a 15-question survey was administered. The survey was completed by 83 providers including 41 anesthesiologists across a variety of care settings.

Findings showed that despite recommendations for a multimodal approach, it is not yet the standard practice:

• Opioids are the most commonly used pain treatment despite potential side effects: nausea, vomiting, itching, constipation and sedation.
• Non-opioids such as acetaminophen and nonsteroidal anti-inflammatory drugs remain largely underused despite having fewer side effects than opioids. 
• 75 percent of respondents only use two agents, typically a narcotic and non-narcotic to treat pain despite evidence that a combination of three or more treatments can significantly improve pain control after surgery.

“The results show that medical providers must continue to educate themselves in current pain management trends and take a more aggressive approach toward the use of a multimodal pain regimen,” said Dr. Baratta. “In addition, it is important for patients to be aware of their options for managing their pain during the surgical process.”

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