• Sandra A van den Heuvel, Regina L van Boekel, Felicia J Cox, Fabrice Ferré, Vincent Minville, Ulrike M Stamer, Kris C Vissers, and Esther M Pogatzki-Zahn.
• From the Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands (SAvdH, RLvB, KCV), Department of Anaesthesiology and Critical Care, Royal Brompton & Harefield Hospitals part of GSST, London, United Kingdom (FJC), Département d'Anaesthésie-Réanimation, Hôpital Pierre-Paul Riquet, Centre Hospitalo-universitaire Purpan, Toulouse, France (FF, VM), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (UMS) and Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Muenster, Muenster, Germany (EMPZ).
• Eur J Anaesthesiol. 2024 Mar 1; 41 (3): 188198188-198.

AbstractThere is general agreement that acute pain management is an important component of perioperative medicine. However, there is no consensus on the best model of care for perioperative pain management, mainly because evidence is missing in many aspects. Comparing the similarities and differences between countries might reveal some insights into different organisational models and how they work. Here, we performed a narrative review to describe and compare the structures, processes and outcomes of perioperative pain management in the healthcare systems of four European countries using Donabedian's framework as a guide. Our comparison revealed many similarities, differences and gaps. Different structures of acute pain services in the four countries with no common definition and standards of care were found. Protocols have been implemented in all countries and guidelines in some. If outcome is assessed, it is mainly pain intensity, and many patients experiencing more intense pain than others have common risk factors (e.g. preoperative pain, preoperative opioid intake, female sex and young age). Outcome assessment beyond pain intensity (such as pain-related physical function, which is important for early rehabilitation and recovery) is currently not well implemented. Developing common quality indicators, a European guideline for perioperative pain management (e.g. for patients at high risk for experiencing severe pain and other outcome parameters) and common criteria for acute pain services might pave the way forward for improving acute pain management in Europe. Finally, the education of general and specialist staff should be aligned in Europe, for example, by using the curricula of the European Pain Federation (EFIC).Copyright © 2023 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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