Current Aspects of Postoperative Pain Care

In the late 1990s the first French consensus conference on postoperative pain care elaborated a modern and ambitious management strategy of postoperative analgesia in adults and children. Prior audits on this subject have been disturbing. The concepts of protocols, multimodal analgesia, self-controlled analgesia, and mandatory assessment of the pain level were first developed. These references helped to guide clinicians in improving the quality of care. In a ten year period the pain management has been individualized. Risk factors of severe pain in the post anesthesia care unit, or chronic pain, are now identified before the surgery. The concept of vulnerability to pain allowed the implementation of combined analgesia individualized for patients’ needs including those at a distance from surgery. Patients of extreme ages were considered as well – a specific pain evaluation scale for non-communicating patients has been validated.The knowledge of pharmacogenomics and patient's personal history is actually a priority for risk management – especially in case of opioids use. Pharmacological meaning of “titration” defines analgesia which fits patients’ needs while limiting opioid doses.However, it is a synergistic interprofessional collaboration that allows patients to benefit from better healthcare delivery including pain control.