Effect of Postoperative Pain Relief on Surgical Outcome

Abstract

Despite much progress within the anesthetic and surgical specialities, major surgical procedures may still be followed by undesirable sequelae such as cardiac, pulmonary, thromboembolic and infective complications. The most important pathogenic factors to determine surgical outcome are various perioperative risk factors and pathophysiological responses included in the general surgical stress response to injury (1). Since trauma-induced nociceptive impulses may initiate autonomic and somatic reflex responses and modify organ functions including those of the endocrine organs, various techniques of postoperative pain relief may therefore alter (inhibit) the surgical stress response, and thereby improve organ dysfunction and overall outcome (1,2). Of the available pain treatment techniques, regional anesthesia with local anesthetics, and especially continuous epidural techniques, are the most powerful analgesic and stress reducing techniques, followed by other epidural regimens (opioids, clonidine etc.), PCA opioids and NSAID’s (2).