6533b838fe1ef96bd12a51f6

RESEARCH PRODUCT

Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines

Federico CoccoliniFrancesco CorradiMassimo SartelliRaul CoimbraIgor A. KryvoruchkoAri LeppaniemiKrstina DoklesticElena BignamiGiandomenico BiancofioreMiklosh BalaCeresoli MarcoDimitris DamaskosWalt L. BifflPaola FugazzolaDomenico SantonastasoVanni AgnolettiCatia SbarbaroMirco NacotiTimothy C. HardcastleDiego MarianiBelinda De SimoneMatti TolonenChad BallMauro PoddaIsidoro Di CarloSalomone Di SaverioPradeep NavsariaLuigi BonavinaFikri Abu-zidanKjetil SoreideGustavo P. FragaVanessa Henriques CarvalhoSergio Faria BatistaAndreas HeckerAlessandro CucchettiGiorgio ErcolaniDario TartagliaJoseph M. GalanteImtiaz WaniHayato KuriharaEdward TanAndrey LitvinRita Maria MelottiGabriele SgangaTamara ZoroAlessandro IsirdiNicola De’angelisDieter G. WeberAdrien M. HodonouRichard TenbroekDario PariniJim KhanGiovanni SbranaCarlo ConiglioAntonino GiarratanoAngelo GratarolaClaudia ZaghiOreste RomeoMichael KellyFrancesco ForforiMassimo ChiarugiErnest E. MooreFausto CatenaManu L. N. G. Malbrain

subject

United StateAnalgesicsPain PostoperativePainAcuteUnited StatesPerioperative CareTreatmentEmergencyAbdomenEmergency MedicineHumansSurgeryAnalgesicAnesthesiaMorbidityHuman

description

Abstract Background Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. Material and methods An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. Conclusion Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.

yearjournalcountryeditionlanguage
2022-09-21
https://hdl.handle.net/11250/3037142