Can we do better with postoperative pain management?
BACKGROUND
In the last decade, there has been heightened awareness that pain management needs to be a priority for all health care settings and clinicians. The article will overview practice guidelines and new technology, and assess their impact on pain relief in inpatient and outpatient surgeries from a patient's perspective.


METHODS
Literature was retrieved by searches from 1996 to 2000 Medline and CINAHL (nursing database), using keywords "postoperative pain," "postsurgical pain," "patient outcomes," "pain outcomes," "survey," "questionnaire," and "practice guidelines."


RESULTS
Overall, current practice standards have had minimal impact on decreasing patients' reports of pain. The incidence of moderate to severe pain with cardiac, abdominal, and orthopedic inpatient procedures has been reported as high as 25% to 50%, and incidence of moderate pain after ambulatory procedures is 25% or higher.


CONCLUSIONS
Despite the advances, the incidence of pain remains high. Yet the future is promising, with new standards from the Joint Commission on Accreditation of Health care Organizations paving the way for reduction of institutional barriers and improved implementation of guidelines.
Huang
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University of Illinois College of Pharmacy, M/C 886, 833 S. Wood St., Rm. 164, Chicago, IL 60612-7230, USA.
Cunningham
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Laurito
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Chen
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D000556:Ambulatory Surgical Procedures; D006801:Humans; D010149:Postoperative Pain / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D010465:Perception; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome