Pain Management Strategies for Urogynecologic Surgery: A Review

ABSTRACT: Surgery-related pain is common and is difficult to manage during the postoperative period. In some studies, more than 30% of patients who underwent either vaginal surgery or abdominal surgery reported inadequate pain control at postoperative days 3 and 7. Poor pain control during the acute postoperative period causes heightened sympathetic discharge (increasing the risk for myocardial infarction and stroke) and decreased ambulation (increasing the risk for thromboembolism). Poor acute postoperative pain control can also result in poor inspiratory effort, resulting in an increased risk for postoperative pneumonia, and central sensitization with resultant chronic pain sequelae. Opioid drug therapy is the current mainstay for management of acute postoperative pain. However, opioid-related adverse drug events occur frequently after gynecologic surgery. Problems such as nausea, vomiting, constipation, drowsiness, sedation, and respiratory depression are common with opioids and often require additional treatment, prolonging the postoperative length of stay. Innovative pain management regimens that minimize opioid use are necessary. The aims of this review were to examine recent evidence on surgical pain management strategies and to identify pain control methods used in urogynecologic surgery. The authors hoped to use existing evidence to suggest future pain management strategies in urogynecologic surgery. A search of PubMed and MEDLINE databases was performed to identify ...
Source: Obstetrical and Gynecological Survey - Category: OBGYN Tags: Gynecology: Urogynecology Source Type: research