Preoperative Chronic Pain Management: Coordination of Surgical and Anesthesiology Services in Preparation for Surgery

Abstract

Perioperative management of chronic pain patients is challenging. System preparation, patient evaluation by both surgical and pain management teams, and preoperative optimization are paramount. Education and training of healthcare providers, building an acute pain management service, and establishing metrics for outcomes are important components of system preparation. Patient evaluation includes a thorough history and physical examination, a psychological evaluation, a review of previous images, and discussion of previous and existing medications and treatment interventions. Preoperative optimization entails education, preoperative adjustment of medication, and treatment of preexisting pain conditions. As part of a multimodal perioperative analgesia plan, premedication and the use of regional anesthesia, preferably with perineural catheters when possible, will optimize postoperative analgesia in this difficult patient population. (PsycINFO Database Record (c) 2017 APA, all rights reserved)