The unsolved problem of postoperative pain: Critical analysis and prospects for improvement

Abstract

Annually, a 5 % rise has been observed in surgical interventions performed worldwide, together with an increase in their complexity as well as in patient comorbidities. However, between 30-80 % of patients experience moderate-intense acute postoperative pain (APD) after the first 24 postoperative hours, despite better pathophysiological knowledge, use of new techniques and analgesic drugs, publication of new guidelines and the creation of the Acute Pain Units (UDA). In addition, we must bear in mind vulnerable patients (pediatric population, pregnant women, the elderly, .) and chronic opioid users who are usually deviations from analgesic protocols and, therefore, place us in a scenario in which the management of Postoperative pain is more difficult and requires the design of personalized strategies for each patient. It must also be borne in mind that inadequate PDA control can lead to chronic postoperative pain, posing a real therapeutic challenge for Chronic Pain Units, together with a deterioration in the patient's quality of life due to its physical repercussions. , psychological and economic. Through this manuscript, we intend to carry out a critical analysis and propose points for improvement in the way we currently manage DAP based on scientific evidence to obtain better postoperative results in the coming years.