Perioperative Pain Management in Gynecologic Oncology Surgery

Abstract

Postoperative pain is a normal reaction to surgical intervention; however, it has been shown to increase morbidity, thus compromising the quality of recovery, which entails a delay in hospital discharge, increased risk of wound infection, and respiratory or cardiovascular complications, with an increase in mortality. Pain syndromes observed in patients with gynecologic oncology pathology result from three primary etiologies: those directly occurring due to the tumor, those deriving from treatments focused on reducing the tumor and those syndromes that are entirely independent of cancer or its treatment. Postoperative pain optimal management requires understanding the pathophysiology of pain and knowing the methods to be able to assess it in each patient, as well as knowledge on the different options available to control it. The key points that have to be considered are: the type of patient, type of surgical procedure, skills of the surgeon and anesthesiologist, and support of the working team. Improving the treatment of postoperative pain requires a broader perspective, since most healthcare providers have been shown to focus only on the postoperative period; however, ideal management is that where interventions are carried out before, during, and after surgery.