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Pharmaceuticals 2014, 7(8), 850-865; doi:10.3390/ph7080850
Review

Pain Management in Ambulatory Surgery—A Review

Received: 18 April 2014; in revised form: 27 June 2014 / Accepted: 9 July 2014 / Published: 24 July 2014
(This article belongs to the Special Issue Anaesthetics)
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Abstract: Day surgery, coming to and leaving the hospital on the same day as surgery as well as ambulatory surgery, leaving hospital within twenty-three hours is increasingly being adopted. There are several potential benefits associated with the avoidance of in-hospital care. Early discharge demands a rapid recovery and low incidence and intensity of surgery and anaesthesia related side-effects; such as pain, nausea and fatigue. Patients must be fit enough and symptom intensity so low that self-care is feasible in order to secure quality of care. Preventive multi-modal analgesia has become the gold standard. Administering paracetamol, NSIADs prior to start of surgery and decreasing the noxious influx by the use of local anaesthetics by peripheral block or infiltration in surgical field prior to incision and at wound closure in combination with intra-operative fast acting opioid analgesics, e.g., remifentanil, have become standard of care. Single preoperative 0.1 mg/kg dose dexamethasone has a combined action, anti-emetic and provides enhanced analgesia. Additional α-2-agonists and/or gabapentin or pregabalin may be used in addition to facilitate the pain management if patients are at risk for more pronounced pain. Paracetamol, NSAIDs and rescue oral opioid is the basic concept for self-care during the first 3–5 days after common day/ambulatory surgical procedures.
Keywords: ambulatory surgery; analgesia; multi-modal analgesia; balanced analgesia; postoperative pain ambulatory surgery; analgesia; multi-modal analgesia; balanced analgesia; postoperative pain
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Jakobsson, J.G. Pain Management in Ambulatory Surgery—A Review. Pharmaceuticals 2014, 7, 850-865.

AMA Style

Jakobsson JG. Pain Management in Ambulatory Surgery—A Review. Pharmaceuticals. 2014; 7(8):850-865.

Chicago/Turabian Style

Jakobsson, Jan G. 2014. "Pain Management in Ambulatory Surgery—A Review." Pharmaceuticals 7, no. 8: 850-865.


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