Postoperative Pain: From Management to Recovery

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Indraneil Mukherjee, MBBS, MD, FACS – Assistant Professor, Zucker School of Medicine, Hofstra University, Northwell, Uniondale, NY, USA
Rayna Walburger, MD – Department of Anesthesia, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Simer Preet Singh, MD, MPH, FAAPMR, FASAM – System Lead Physician for Spine and Pain Medicine, Rochester Regional Health System, Rochester, NY, USA

Series: Pain Management – Research and Technology
BISAC: MED085000
DOI: https://doi.org/10.52305/LKRZ1385

Most patients who undergo surgery will experience acute postoperative pain, making postoperative pain management an important topic. Pain management has shifted towards a multimodal approach and away from the traditional opioid administration due in part to the opioid crisis. As opioids came to be abused, with many starting after initially being prescribed opioids by their physician, the focus on how to manage pain changed. However, a multimodal approach also has benefits outside of decreasing use of opioids such as targeting multiple pathways of pain to lead to more favorable outcomes for patients. A multimodal approach does not consist of the same approach for each patient. It gives the ability to tailor the pain management approach to the patient and the type of surgery. In this textbook, the approach to postoperative pain management for different surgeries will be highlighted. The different modalities used for a multimodal approach will be defined with their underlying pathophysiology explained. This textbook will give a basic understanding of how the combination of multiple medications often results in superior outcomes, with better patient satisfaction and often lower doses being required due the additive effects of different pathways being targeted.

Table of Contents

Preface

Chapter 1. Enhanced Recovery After Surgery
Jonathan Gardy Alabre
City University of New York School of Medicine, New York, NY, USA

Chapter 2. Multimodal Analgesia
Katrina Kerolus and Rayna Walburger, MD
City University of New York School of Medicine, New York, NY, US

Chapter 3. Intravenous Opioids
Alice Lee
City University of New York School of Medicine, New York, NY, US

Chapter 4. Oral Opioids
Chase Skillin, DO
Touro College of Osteopathic Medicine, New York, NY, USA

Chapter 5. Non-Steroidal Anti-Inflammatory Drugs
Mark El-Miniawi1, Jessica El-Miniawi2 and Khosrow Kashfi1, PhD
1City University of New York School of Medicine, New York, NY, USA
2Memorial Sloan Kettering, New York, NY, USA

Chapter 6. Ketamine: Nonopioid Perioperative Analgesia
Rayna Walburger, MD
Icahn School of Medicine at Mount Sinai, New York, NY, USA

Chapter 7. Local Anesthetics
Joseph Kennedy, MD
City University of New York School of Medicine, New York, USA

Chapter 8. Alvimopan: Peripheral Mu-Opioid Receptor Antagonist
Jonathan Gardy Alabre
City University of New York School of Medicine, New York, NY, USA

Chapter 9. Epidural and Spinal Anesthesia
Chikadibia Agoha
City University of New York School of Medicine, New York, NY, USA

Chapter 10. Regional Anesthesia for Truncal Surgery (Thorax + Abdomen)
Fatma Shalan and Joseph Kennedy
City University of New York School of Medicine, New York, NY, USA

Chapter 11. Peripheral Nerve Blocks for Orthopedic Surgeries
Rayna Walburger, MD
Icahn School of Medicine at Mount Sinai, New York, NY, USA

Chapter 12. Patient-Controlled Anesthesia Pump
Alice Lee
City University of New York School of Medicine, New York, NY, USA

Chapter 13. Oral Analgesia for Intubated Patients
Fatma Shalan and Joseph Kennedy
City University of New York School of Medicine, New York, NY, USA

Chapter 14. Postoperative Pain in Patients Who Are on Chronic Opioids
Alice Lee
City University of New York School of Medicine, New York, NY, USA

Chapter 15. Perioperative Considerations and Anesthetic Management of the Geriatric Population
Shreya Reddy
City University of New York School of Medicine, New York, NY, USA

Chapter 16. Postoperative Pain in Head and Neck Procedures
Nikhilesh Chitibomma1, Juan Garces1 and Alice Lee2
1Staten Island University Hospital – Northwell Health, New York, NY, USA
2City University of New York School of Medicine, New York, NY, USA

Chapter 17. Postoperative Pain Management in Ophthalmic Plastic and Reconstructive Surgery
Gabriella Schmuter, MD1; Emery C. Jamerson, MD2
1
Department of Ophthalmology, Weill Cornell Medicine, New York, NY
2Department of Oculoplastic & Orbital Surgery, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY

Chapter 18. Postoperative Pain Management for Colorectal Surgery
Jonathan Gardy Alabre
City University of New York School of Medicine, New York, NY, USA

Chapter 19. Post-Ooperative Pain Management in Urological Surgery
Mark El-Miniawi1 and Dr. Miguel Pineda2, MD
1City University of New York School of Medicine, New York, NY, US
2Staten Island University Hospital – Northwell Health, New York, NY, US

Chapter 20. Postoperative Pain Management in the Vascular Patient
Thomas Kania, MD and Kiara Singer, DO
Staten Island University Hospital – Northwell Health, New York, NY, USA

Chapter 21. Obstetric Postoperative Pain
Alexandra Over and Ana Christina Reyes
Touro School of Osteopathic Medicine, New York, NY, USA

Chapter 22. Analgesia for Office and Ambulatory Procedures
Nikhilesh Chitibomma1, Juan Garces1 and Gregory Haskin2
1
Staten Island University Hospital – Northwell Health, New York, NY, USA
2Touro College of Osteopathic Medicine, New York, NY, USA

Chapter 23. Pain Management in Fracture Reduction
Kaulin J. Ervin, DO
Touro College of Osteopathic Medicine, New York, NY, USA

Chapter 24. Psychiatric Comorbidities with Pain
Jennifer Puthota and Joseph Kennedy
City University of New York School of Medicine, New York, NY, USA

Chapter 25. VR Glasses for Postoperative Pain
Tanzib Razzaki
City University of New York School of Medicine, New York, NY, USA

Index