• Girish P Joshi, Stephan A Schug, and Henrik Kehlet.
• University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390-9068, USA. Electronic address: girish.joshi@utsouthwestern.edu.
• Best Pract Res Clin Anaesthesiol. 2014 Jun 1; 28 (2): 191-201.

AbstractOptimal dynamic pain relief is a prerequisite for optimizing post-operative recovery and reducing morbidity and convalescence. Procedure-specific pain management initiative aims to overcome the limitations of conventional guidelines and provide health-care professionals with practical recommendations formulated in a way that facilitates clinical decision making across all the stages of the perioperative period. The procedure-specific evidence is supplemented with data from other similar surgical procedures and clinical practices to balance benefits and risks of each analgesic technique. There is emphasis on the use of multimodal analgesia and preventive analgesia aimed at reducing central sensitization. Importantly, the benefits of dynamic pain relief may only be realized if other aspects of perioperative care such as the use of minimally invasive surgery, approaches to reduce stress responses, optimizing fluid therapy and optimizing post-operative nursing care with early mobilization and oral feeding are utilized.Copyright © 2014 Elsevier Ltd. All rights reserved.

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