Postoperative acute pain

Multiple factors contribute to poor postoperative pain control, including: inadequate assessment by nursing and physicians and erroneous beliefs that surgical pain is inevitable and acceptable and that it has harmless consequences for the sufferers. Postoperative acute pain after spine surgery is usually described as moderate to severe with its maximum within the first 3 days after surgery. Postoperative acute pain after spine surgery causes functional interference and is one of the leading causes of readmission after ambulatory spine surgery. The importance of achieving successful postoperative acute pain management is due to the fact that postoperative pain is associated with complications such as poor early mobilization, deep venous thrombosis, urinary infection, and delayed return of bowel function. Due to the complex physiology behind postoperative acute pain after spine surgery, multimodal analgesia appears to be the most effective approach for pain control. Intravenous patient-controlled analgesia (IV PCA) has been shown to be better than “around the clock” administration of analgesic but might not be sufficient for pain control after major spine surgeries. Epidural administration of local anesthetics has proven to reduce postoperative acute pain after spine surgery; however, there are still controversies regarding their use because they can potentially mask early symptoms of spinal bleeding. Introduction The International Association for Study of Pain defined pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Accordingly, the ability to detect pain is essential to avoid further tissue damage. Despite this definition and tremendous efforts from scientific and medical societies, there continue to be barriers to effective postoperative pain management. Poorly controlled postoperative pain is a major impediment to postoperative functional recovery and is a persistent problem in the United States. Multiple factors have been identified to contribute to this problem, including its inadequate assessment by nurses and physicians and erroneous beliefs that surgical pain is inevitable and acceptable and that it has harmless consequences for the sufferers.