Reconceptualizing Acute Pain Management in the 21st Century

Stephen Macres; Robin J Aldwinckle; Usha Saldahna; Scott G Pritzlaff; Michael Jung; Josh Santos; Mariya Kotova; Robert Bishop

doi:10.1016/j.aan.2023.06.006

Reconceptualizing Acute Pain Management in the 21st Century

Adv Anesth. 2023 Dec;41(1):87-110. doi: 10.1016/j.aan.2023.06.006. Epub 2023 Aug 21.

Authors

Stephen Macres¹, Robin J Aldwinckle², Usha Saldahna³, Scott G Pritzlaff⁴, Michael Jung⁵, Josh Santos⁶, Mariya Kotova⁷, Robert Bishop⁸

Affiliations

¹ Department of Anesthesiology and Pain Medicine, University of California, Davis Medical Center, 4150 V. Street, Sacramento, CA 95817, USA. Electronic address: [email protected].
² Anesthesiology, Department of Anesthesiology & Pain Medicine, 4150 V. Street, PSSB Suite 1200, Sacramento, CA 95817, USA.
³ Regional Anesthesia Fellowship, Department of Anesthesiology and Pain Medicine, University of California, Davis Medical Center, 4150 V. Street, Sacramento, CA 95817, USA.
⁴ Division of Pain Medicine, Pain Medicine Fellowship, Department of Anesthesiology and Pain Medicine, University of California, Davis Medical Center, 4860 Y. Street, Suite 3020, Sacramento CA 95817, USA.
⁵ Pain Fellowship, Department of Anesthesiology and Pain Medicine, UC Davis Medical Center, 4860 Y. Street, Suite 3020, Sacramento CA 95817, USA.
⁶ Pre-Anesthesia Readiness & Education Program, 4150 V. Street, Sacramento, CA 95817, USA.
⁷ Department of Pharmacy, UC Davis Medical Center, 1240 47th Avenue, Sacramento, CA 95831, USA.
⁸ Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, Sacramento, CA, USA.

PMID: 38251624
DOI: 10.1016/j.aan.2023.06.006

Abstract

Acute pain can have many etiologies that include surgical procedures, trauma (motor vehicle accident), musculoskeletal injuries (rib fracture) and, burns among others. Valuable components of a multimodal approach to acute pain management include both opioid and non-opioid medications, procedure specific regional anesthesia techniques (peripheral nerve blocks and neuraxial approaches), and interventional approaches (eg, peripheral nerve stimulation and cryo-neurolysis). Overall, successful acute perioperative pain management requires a multimodal, multidisciplinary approach that involves a coordinated effort between the surgical team, the anesthesia team, nursing, and pharmacy staff using Enhanced Recovery After Surgery (ERAS) protocols.

Keywords: Acute pain management of the opioid-dependent patient; Acute pain team organization; Acute perioperative pain management; Biased opioid ligand; Cryo-neurolysis and acute pain; Opioid use disorder; Peripheral nerve stimulation and acute pain; Transitional pain service.

Publication types

Review

MeSH terms

Accidents, Traffic
Acute Pain* / diagnosis
Acute Pain* / therapy
Anesthesia, Conduction*
Humans
Pain Management
Transcutaneous Electric Nerve Stimulation*