title: Pain management strategies for urogynecologic surgery: a review.
abstract: OBJECTIVE
  The objectives of this study were to review the recent literature on surgical pain management strategies and to identify those pertinent to urogynecologic surgery.
  
  
  METHODS
  A literature search using Pubmed and MEDLINE was performed for trials on pain management in gynecologic surgery. Evidenced-based recommendations for preoperative, intraoperative, and postoperative pain control strategies for gynecologic procedures by various surgical routes were identified. Articles specifically describing urogynecologic procedures were sought, but quality, randomized trials on pain management modalities in other gynecologic procedures were also included.
  
  
  RESULTS
  Although few randomized trials on pain management strategies in urogynecologic surgery exist, quality evidence suggests that several preemptive and multimodal analgesia strategies reduce pain and opioid-related adverse events in abdominal, laparoscopic, and vaginal surgery. Evidence supporting these strategies is outlined. Many are likely applicable to urogynecologic procedures.
  
  
  CONCLUSIONS
  Evidence guiding pain management in specific urogynecologic procedures is sparse and should be sought in future studies. When possible, procedure-specific strategies, including preemptive and multimodal techniques, should be implemented.
authors.affiliation: From the *Department of Obstetrics and Gynecology, Section of Gynecology and Reconstructive Pelvic Surgery, University of Chicago Medicine, Chicago, IL; †Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Houston, TX; ‡Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK; and §Department of Obstetrics and Gynecology, Division of Urogynecology, Hartford Hospital, University of Connecticut Health Center, Hartford, CT.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Collins
authors.forename: Girish
authors.initials: G
authors.lastname: Joshi
authors.forename: Lieschen H
authors.initials: LH
authors.lastname: Quiroz
authors.forename: Adam C
authors.initials: AC
authors.lastname: Steinberg
authors.forename: Mikio A
authors.initials: MA
authors.lastname: Nihira
mesh_terms: D000698:Analgesia / Q000379:methods; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects; D059408:Pain Management / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D013519:Urogenital Surgical Procedures / Q000009:adverse effects*