SCIENTIFIC UPDATE ON POST-OPERATIVE PAIN MANAGEMENT IN ORTHOPEDIC SURGERY

Postoperative pain results from the nociceptive stimulus caused by the surgical aggression, coming from direct or indirect mechanisms. Its intensity and duration depends on several factors, mainly the type of surgical approach, surgical access and anatomy. Orthopaedic surgeries are considered one of the most painful, due to the intense nociceptive stimulation of the musculoskeletal tissue.The prevalence of post-operative pain is described in 73% of patients who experience moderate to severe pain on the first day after surgery. A lower prevalence is observed in developed countries, due to pain protocols, the presence of acute pain services and advanced general anesthesia techniques. Numerous protocols have been tested, and opioids are often the drugs of choice, but the events are considered the biggest drawback. Pain control can be achieved through the use of certain medications, the use of physical means and interventions related to cognitive behavior, such as educational techniques and relaxation. Even though it is difficult to treat pain, analgesic methods are essential to reduce the incidence of persistent pain, avoiding and alleviating future chronic pain conditions that are difficult to treat.