Pre– and postoperative pain control in the surgical patient is an important aspect of effective patient care and has a direct bearing on outcome. In patients with noncancer (benign) pain, surgery is typically not emergent, unless associated with trauma. In the midst of the opioid epidemic, effective pain management is challenging.
Pain management before surgery may impact preoperative assessment and care. Patients on chronic or high dose opioids may not be good surgical candidates, due not only to issues with pain control and dosing, but to inactivity-related deconditioning. On the contrary, patients with adequate pain control may be able to participate in a rehabilitative program pre– and postoperatively. Prior to surgery, non-opioid medications such as nonsteroidal anti-inflammatory medications and acetaminophen, and non-pharmacologic interventions, such as physical therapy, chiropractic and alternative treatments may be helpful in avoiding opioid-related issues.