Revista de la Sociedad Española del Dolor
versión impresa ISSN 1134-8046
ESTEVE PEREZ, N. et al. Postoperative analgesia after surgery: should we change our protocols?. Rev. Soc. Esp. Dolor [online]. 2009, vol.16, n.4, pp.239-245. ISSN 1134-8046.
Postoperative analgesia is one of the basic components of functional recovery after surgery. However, separating the effects of postoperative analgesia from other factors such as the surgical technique, clinical practice, the type of analgesic follow-up and the organizational factors of the surgical team can be difficult. The introduction of laparoscopy, thoracoscopy and minimally-invasive surgical techniques are modifying the traditional protocols used in complex surgery. Intravenous patient-controlled analgesia and even oral opioids are replacing epidural analgesia in this type of technique. Evaluation of the risk/benefit ratio for the selection of the proper postoperative analgesia technique depends on the severity of dynamic pain and the potential adverse effects of analgesic drugs and techniques. Demonstrating the impact of postoperative analgesia on major outcomes such as surgical mortality, morbidity, or length of stay, can be difficult as these outcomes depend on multiple and heterogeneous factors. The effect of a specific type of analgesia on the entire surgical process should be investigated on the basis of patient-oriented outcomes, such as the quality of analgesia, adverse effects and postoperative comfort. Other areas in which postoperative analgesia could have a postoperative impact are those related to oncological recurrence and chronic postoperative pain.
Palabras clave : Postoperative pain; Epidural analgesia; Regional analgesia; Intravenous analgesia; Laparoscopy.