Different routes of administration that benefit in acute postoperative pain management

Successfully treating postoperative acute pain, along with early mobilization as well as nutrition, is one of the perioperative techniques proposed to improve surgical outcomes and reduce the costs of hospitalization.

Also, sufficient pain control decreases perioperative morbidity associated with surgical stress and can also avoid the development of chronic postoperative pain syndromes, treating which is still a huge challenge. Hence, route of drug administration, the best dosage for that route, and unique limitations and contraindications for every patient should be also considered along with the choice of drug class to be used.

A group of researchers from Italy conducted a comprehensive analysis on the different routes of administration of acute postoperative pain medications and their indications and limitations, focusing on recent evidence and international recommendations.

The researchers thoroughly searched various databases for recent studies regarding postoperative pain, oral medication, intravenous medications, epidural route, intrathecal route, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, local anesthetics, peripheral blocks, adjuvants.

Hence, the conclusion derived by the authors are based on previously conducted studies and do not contain any new studies with human participants or animals.

The researchers concluded the following:

· A multimodal pain control way that includes a variety of analgesic and non-pharmacological interventional techniques ensure better analgesia than a single intervention.

· The knowledge of indications and limitations of the different routes of administration of acute pain drugs could be useful in achieving better pain relief.

· The oral route is the route of choice, unless contraindicated; while the intramuscular route is highly discouraged.

· Epidural analgesia is highly advised for patients who undergo major thoracic and abdominal procedures, hip surgery, and lower extremity surgery, particularly in patients at risk for cardiac or pulmonary complications, or prolonged ileus

· Peripheral blocks are advised for surgery at the extremities and in abdominal, breast, or thoracic surgery

· Accurate monitoring is needed in all cases to prevent complications

For more information refer to:

"The Routes of Administration for Acute Postoperative Pain Medication" by Puntillo F published in the Pain and Therapy journal.

https://link.springer.com/article/10.1007/s40122-021-00286-5