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Psychiatric Aspects of Perioperative Pain

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Perioperative Psychiatry

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Abstract

Postoperative pain, defined as the acute pain experienced after a surgical procedure, is nearly universal after surgery. When not managed well, it contributes to delayed functional recovery and increased risk of postsurgical complications such as poor wound healing. Preoperative education about pain management, expectations, and available treatments has been shown to reduce postoperative anxiety, opioid requirement, sedative dose, and length of stay after surgery.

Multimodal approaches to managing postoperative pain are the standard of care and yield the best clinical outcomes. They involve a combination of opioid and non-opioid pharmacotherapy along with non-pharmacological interventions including behavioral, psychological, and physical therapies. Monitoring of postoperative pain should include prompt identification of surgical or medical complications in the postoperative period, verification of the half-life, dose and scheduling of analgesic medications, and assessment for physiological dependence or a comorbid substance use disorder. Adequate and safe management of pain after discharge are essential. Prolonged postoperative use of opioids can lead to chronic pain, which is a known adverse outcome of surgery and is costly in terms of suffering, morbidity, and disability.

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Authors and Affiliations

  1. Department of Psychiatry, Yale University, New Haven, CT, USA

    Teofilo E. Matos Santana

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  1. Teofilo E. Matos Santana
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Correspondence to Teofilo E. Matos Santana .

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Editors and Affiliations

  1. Department of Psychiatry, New Haven, CT, USA

    Paula C. Zimbrean

  2. Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA

    Mark A. Oldham

  3. Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA

    Hochang Benjamin Lee

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Santana, T.E.M. (2019). Psychiatric Aspects of Perioperative Pain. In: Zimbrean, P., Oldham, M., Lee, H. (eds) Perioperative Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-99774-2_6

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  • DOI: https://doi.org/10.1007/978-3-319-99774-2_6

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