Abstract
Postoperative, incisional pain is the common form of acute pain. The understanding of acute pain mechanisms has advanced. This article reviews postoperative pain and proposes mechanisms for enhanced excitability of sensory neurons caused by incisions. Because effective postoperative analgesia reduces morbidity following surgery, new treatments continue to be sought. The use of regional analgesia and/or opioid via a catheter, e.g. epidural analgesia (EDA), continuous epidural infusion with patient control analgesia (CED+PCA) or patient controlled intravenous analgesia (PCIA), continuous subcutaneous infusion (+PCA) has become popular. These methods require special equipment, adequate nursing skills and professional expertise as well as the establishment of clinical procedures and an appropriate logistic setup. However, post-operative pain and cancer pain in the majority of patients is underestimated and cannot be ignored due to lack of knowledge of the proper use of basic analgesic treatment. Therefore, it makes sense to establish a standardized step-concept of postoperative pain and cancer pain management with regular quality control integrated into a multimodal program.
