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Clinical Updates on Perioperative Pain Management: 2nd Edition
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Clinical Updates on Perioperative Pain Management: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 2940

Special Issue Editors

Prof. Dr. Felice Eugenio Agro

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Guest Editor
Anesthesia, Intensive Care and Pain Management, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
Interests: anesthesia; airway management; difficult airway; mechanical ventilation; extra-glottic airway devices; resuscitation; analgesia; pain management; regional anesthesia; neuromuscular monitoring; COVID-19; fluid therapy
Special Issues, Collections and Topics in MDPI journals
Dr. Giuseppe Pascarella

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Guest Editor
Anesthesia, Intensive Care and Pain Management, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
Interests: anesthesia and intensive care; airway management; regional anesthesia; analgesia; pain management; postoperative pain; knee replacement arthroplasties; breast surgery; thoracotomy; orthopedic surgery; hip surgery; ultrasound
Special Issues, Collections and Topics in MDPI journals
Dr. Fabio Costa

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Guest Editor
Anesthesia, Intensive Care and Pain Management, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
Interests: anesthesia and intensive care; pain management; regional anesthesia; analgesia; postoperative pain; knee replacement arthroplasties; breast surgery; thoracotomy; orthopedic surgery; hip surgery; ultrasound
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to the Special Issue entitled “Clinical Updates on Perioperative Pain Management: 2nd Edition”. This is one new volume; we published nine papers in the first volume. For more details, please visit the following link:
https://www.mdpi.com/journal/jcm/special_issues/F925ASF1UQ

Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors. Optimal perioperative pain management positively impacts the quality of patients’ recovery, reducing the incidence of complications.

For this reason, multimodal approaches, including regional anesthesia techniques, analgesics drugs, and rehabilitation programs, play key roles in the field of research, used with the aim to improve perioperative analgesia. For this Special Issue, we welcome original high-quality works about the use of innovative regional anesthesia techniques, including neuraxial blocks, peripheral nerve blocks, and fascial plane blocks, to treat perioperative pain. Moreover, papers investigating the use of specific drugs, rehabilitation protocols, or innovative devices to manage perioperative analgesia will be considered. Accepted manuscripts may be in the form of research papers, original studies, or reviews.

Prof. Dr. Felice Eugenio Agro
Dr. Giuseppe Pascarella
Dr. Fabio Costa
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anesthesia and intensive care
  • pain management
  • spinal anesthesia
  • postoperative pain
  • breast surgery
  • fascial plane blocks
  • abdominal surgery
  • cardiac surgery
  • thoracotomy
  • knee surgery
  • orthopedic surgery
  • hip surgery
  • ultrasound

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Related Special Issue

Published Papers (4 papers)

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Research

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11 pages, 905 KiB  
Article
A Comparison of Two Fascial Plane Blocks for Abdominal Analgesia in Laparoscopic Cholecystectomy Surgery (M-TAPA vs. External Oblique Intercostal Plane Block): A Prospective Randomized Study
by Bahadir Ciftci, Selcuk Alver, Birzat Emre Gölboyu, Mustafa Celalettin Haksal, Serkan Tulgar, Alessandro De Cassai and Haci Ahmet Alici
J. Clin. Med. 2025, 14(9), 3050; https://doi.org/10.3390/jcm14093050 - 28 Apr 2025
Viewed by 406
Abstract
Background: Modified thoracoabdominal nerve block through a perichondrial approach (M-TAPA) and external oblique intercostal plane block (EOIB) provide abdominal analgesia by blocking thoracoabdominal nerves. Our aim was to compare the analgesic efficacy of M-TAPA vs. EOIB on the quality of recovery and pain [...] Read more.
Background: Modified thoracoabdominal nerve block through a perichondrial approach (M-TAPA) and external oblique intercostal plane block (EOIB) provide abdominal analgesia by blocking thoracoabdominal nerves. Our aim was to compare the analgesic efficacy of M-TAPA vs. EOIB on the quality of recovery and pain scores in patients who underwent laparoscopic cholecystectomy surgery (LC). Methods: Patients with American Society of Anesthesiologists status I-II, aged between 18 and 65 years, and scheduled for elective LC under general anesthesia were enrolled in the study. The patients were randomized into two groups: Group M-TAPA (n = 30) and Group EOIB (n = 30). The blocks were performed with 40 mL 0.25% bupivacaine in total. The primary outcome of the study was the global quality of recovery score, and the secondary outcomes were the pain scores, rescue analgesic requirement, and adverse effects during the 24-h postoperative period. Results: The global quality of recovery scores at 24 h were similar in both groups. There was a reduction in the median static and dynamic numerical rating scale (NRS) in the first 2 h postoperatively for M-TAPA compared to the EOIB (p < 0.001). The need for rescue analgesia was significantly lower in the M-TAPA group compared to the EOIB group (p < 0.005). Conclusions: Opioid consumption was lower in the M-TAPA group, and the pain scores of the two groups were similar, with the exception of the first 2 h postoperatively. Both the M-TAPA block and EOIB are effective for analgesia following laparoscopic abdominal surgeries. Full article
(This article belongs to the Special Issue Clinical Updates on Perioperative Pain Management: 2nd Edition)
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16 pages, 857 KiB  
Article
Prospective Survey of Postoperative Pain in Japan: A Multicenter, Observational Study
by Masaki Kaibori, Kengo Yoshii, Tung Thanh Lai, Hideyuki Matsushima, Wataru Tatsuishi, Ryo Inada, Yasuhiro Matsugu, Koji Komeda, Mitsuhiro Asakuma, Keitaro Tanaka, Hiroshi Sato, Takeshi Yamada, Toshimitsu Miyasaka, Yutaka Hasegawa, Ryota Matsui, Kazuhiro Takehara, Saiho Ko, Ichiro Yamato, Naohiro Washizawa, Hideki Taniguchi, Yutaka Kimura, Nobuya Ishibashi, Yoshito Akagi, Naoko Hiki, Tadashi Higuchi, Tatsushi Shingai, Takashi Kamei, Hiroshi Okamoto, Yuichi Nagakawa, Chie Takishita, Takayuki Kohri, Kosuke Matsui, Yoshihiro Nabeya, Kazuhiko Fukatsu and Go Miyataadd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(4), 1130; https://doi.org/10.3390/jcm14041130 - 10 Feb 2025
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Abstract
Background/Objectives: Postoperative analgesia is important for reducing biologically invasive reactions to surgery. In Japan, postoperative analgesia, including indices of analgesia, has not been adequately addressed. This study aimed to determine the relationship between postoperative pain and postoperative course and the importance of [...] Read more.
Background/Objectives: Postoperative analgesia is important for reducing biologically invasive reactions to surgery. In Japan, postoperative analgesia, including indices of analgesia, has not been adequately addressed. This study aimed to determine the relationship between postoperative pain and postoperative course and the importance of analgesia for early recovery. Methods: Patients who underwent any of seven surgical procedures in gastrointestinal, thoracic, and cardiac surgery were enrolled. The primary endpoint was a median Prince Henry Pain Scale score from postoperative days 1 to 3. Secondary endpoints were the quality of recovery on postoperative day 7 (Quality of Recovery-15 [QoR-15]) and the length of postoperative hospital stay. Results: Median postoperative pain levels among surgeries were 3 on day 1, 2 on days 2 and 3, 1 on day 7, and 1 at discharge. In both univariate and multivariate analyses, the use of postoperative epidural analgesia and intravenous patient-controlled analgesia (IV-PCA) were significant predictors of early postoperative pain. Only early postoperative pain was a significant predictor of QoR-15 score. Regular use of acetaminophen, early postoperative pain, no appetite, and postoperative complications were significant in affecting the length of postoperative hospital stay. In the comparison of early postoperative pain according to whether epidural analgesia and IV-PCA were used, the group that used both methods had the least pain. Conclusions: In Japan, early postoperative pain persists after major surgical procedures and affects postoperative quality of recovery and length of hospital stay. The use of epidural analgesia, IV-PCA, or both appeared to be effective in overcoming early postoperative pain, thereby enhancing early postoperative recovery. Full article
(This article belongs to the Special Issue Clinical Updates on Perioperative Pain Management: 2nd Edition)
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Review

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18 pages, 4615 KiB  
Review
The Effect of Transversus Abdominis Plane Block on Pain-Related Outcomes in Kidney Transplantation: A Systematic Review with Meta-Analysis and Trial Sequential Analysis
by Dmitriy Viderman, Mina Aubakirova, Fatima Nabidollayeva, Anuar Aryngazin, Nekane Romero-Garcia, Rafael Badenes and Yerkin G. Abdildin
J. Clin. Med. 2025, 14(6), 1879; https://doi.org/10.3390/jcm14061879 - 11 Mar 2025
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Abstract
Background/Objectives: Due to post-surgical discomfort in kidney transplant recipients and donors as well as opioids’ multiple side effects, alternative analgesic methods are required in renal transplant surgeries. This study aimed to evaluate the analgesic effect of the transversus abdominis plane (TAP) block [...] Read more.
Background/Objectives: Due to post-surgical discomfort in kidney transplant recipients and donors as well as opioids’ multiple side effects, alternative analgesic methods are required in renal transplant surgeries. This study aimed to evaluate the analgesic effect of the transversus abdominis plane (TAP) block versus no-block controls in kidney transplantation patients. Methods: We conducted a meta-analysis with a trial sequential analysis (TSA) of randomized controlled trials (RCTs). We searched for relevant articles in PubMed, Scopus, and the Cochrane Library published before December 2023. Protocol registration: doi.org/10.17605/OSF.IO/PMZJ4. Results: A total of 11 RCTs were included in the meta-analysis. The TAP block group had lower pain intensity on postoperative day 1 (mean difference, MD = −0.65 [−0.88, −0.42]; p < 0.00001) than the control group. However, the heterogeneity among the included studies was considerable (I2 = 93%). Subgroup meta-analysis and TSA revealed a significant pain reduction at 24 h postoperatively in donors (MD = −0.70 [−1.16, −0.24]; p = 0.003); heterogeneity was substantial (I2 = 67%). The TAP block group also had lower overall morphine consumption within 24 h (MD = −4.82 [−7.87, −1.77]; p = 0.002) and cumulative 24 h morphine use (MD = −14.13 [−23.64, −4.63]; p = 0.004); however, heterogeneity was considerable (I2 = 98% in both cases). The time to first analgesia (hours) was significantly longer in the TAP block group (MD = 5.92 h [3.63, 8.22]; p < 0.00001, n = 3). There was no significant difference between the groups in postoperative nausea and vomiting (risk ratio, RR = 0.91 [0.49, 1.71]; p = 0.78). Conclusions: TAP block can lower pain intensity and reduce morphine consumption on the first postoperative day in patients undergoing renal transplantation. Pain reduction is especially notable in the subgroup of donors, but the benefits reported are minimum and certainly not clinically relevant. Larger, well-powered RCTs are warranted to confirm these results and evaluate the effect of TAP block in the subgroup of recipients. Full article
(This article belongs to the Special Issue Clinical Updates on Perioperative Pain Management: 2nd Edition)
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Other

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15 pages, 783 KiB  
Study Protocol
Patient Controlled Intravenous Analgesia with Oxycodone or Sufentanil After Hip Surgery: Study Protocol for a Multi-Centered, Randomized Controlled Trial
by Chenxi Liao, Haibei Zhu, Jie Zhong, Xingning Lai, Boyi Zhang and Ren Liao
J. Clin. Med. 2025, 14(5), 1525; https://doi.org/10.3390/jcm14051525 - 25 Feb 2025
Viewed by 536
Abstract
Background: Patient-controlled intravenous analgesia (PCIA) after hip surgery should be focused on sufficient analgesia, recovery, and the risk of adverse effects. Sufentanil PCIA offers effective analgesia but with obvious side effects. Oxycodone, a semi-synthetic opioid, is reported to have good analgesic effects [...] Read more.
Background: Patient-controlled intravenous analgesia (PCIA) after hip surgery should be focused on sufficient analgesia, recovery, and the risk of adverse effects. Sufentanil PCIA offers effective analgesia but with obvious side effects. Oxycodone, a semi-synthetic opioid, is reported to have good analgesic effects with fewer adverse effects compared to strong opioids. We hypothesize that in hip surgery, compared with sufentanil PCIA, oxycodone PCIA in an equipotent dose to sufentanil could achieve similar postoperative analgesia while reducing the incidence of adverse effects associated with strong opioids. Methods: This multi-centered, randomized, controlled open-label clinical trial compares the efficacy of oxycodone and sufentanil for PCIA in hip surgery patients. Results: A total of 570 subjects will be randomly allocated in a 1:1 ratio into either the oxycodone group or sufentanil group. The primary outcome is the resting numerical rating scale (NRS) pain scores at 2 h after surgery. The secondary outcomes include the incidence of postoperative nausea and vomiting (PONV), NRS pain scores on movement, complications, mobilization time, length of hospital stay, total in-hospital cost, etc. Conclusions: This trial will provide evidence for the choice of PCIA in hip surgery by comparing the analgesic efficacy and side effects of oxycodone and sufentanil, serving as a foundation for postoperative pain management guidelines and recommendations. Trial Registration: Clinical Trials NCT03685188. Full article
(This article belongs to the Special Issue Clinical Updates on Perioperative Pain Management: 2nd Edition)
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