Revision of expert panel's guidelines on postoperative pain management

Anaesth Crit Care Pain Med. 2019 Aug;38(4):405-411. doi: 10.1016/j.accpm.2019.02.011. Epub 2019 Feb 26.

Abstract

The French Society of Anaesthesia and Intensive Care Medicine (SFAR) published experts' guidelines on the care of postoperative pain. This was an update of the 2008 guidelines. Fourteen experts analysed the literature (PubMed™, Cochrane™) on questions that had not been treated in the previous guidelines, or to modify the guidelines following new data in the published literature. The used method is invariably the GRADE© method, which guarantees a rigorous work. Seventeen recommendations were formalised on the assessment of perioperative pain, and most particularly in non-communicating patients, on opioid and non-opioid analgesics and on anti-hyperalgesic drugs, such as ketamine and gabapentinoids, as well as on local and regional anaesthesia. The concept of vulnerability and therefore the identification of the most fragile patients in terms of analgesics requirements were specified. Because of the absence of sufficient data or new information, no recommendation was made about analgesia monitoring, the procedures for the surveillance of patients in conventional care structures, or perinervous or epidural catheterism.

Keywords: Postoperative pain; Update of experts’ guidelines.

Publication types

  • Practice Guideline

MeSH terms

  • Adolescent
  • Adult
  • Analgesia, Epidural / methods
  • Analgesics / administration & dosage
  • Analgesics / adverse effects
  • Analgesics / therapeutic use*
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Catheterization, Peripheral
  • Child
  • Child, Preschool
  • Contraindications, Drug
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use
  • Drug Administration Routes
  • Drug Interactions
  • Hemorrhage / chemically induced
  • Hemorrhage / prevention & control
  • Humans
  • Infant
  • Infant, Newborn
  • Ketamine / administration & dosage
  • Ketamine / therapeutic use
  • Lidocaine / administration & dosage
  • Lidocaine / therapeutic use
  • Monitoring, Physiologic / methods
  • Monitoring, Physiologic / standards
  • Pain Management / methods
  • Pain Management / standards*
  • Pain Measurement
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / therapy
  • Risk Factors

Substances

  • Analgesics
  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Ketamine
  • Dexamethasone
  • Lidocaine