Rapid Review Quiz: Postoperative Pain Management
Recent clinical guideline updates for managing postoperative pain emphasize increased use of non-opioid treatments and multimodal strategies. This reflects growing recognition that while opioids are effective, they pose risks such as dependence and adverse side effects. Nonpharmacological and non-opioid interventions such as nonsteroidal anti-inflammatory drugs, NMDA receptor antagonists like ketamine, peripheral nerve blocks, and techniques like transcutaneous electrical nerve stimulation have been shown to reduce opioid use, improve pain control, and enhance recovery outcomes, especially when healthcare professionals are adequately trained to apply them. Randomized controlled trials support the efficacy of peripheral nerve stimulation for postsurgical pain, and evidence for this and other novel therapies continues to grow. Even patient factors such as sleep quality and the timing of surgery can significantly impact post-operative pain.
Programmed intermittent epidural bolus injection was shown to be more effective than other methods in improving both nighttime pain management and sleep quality in post-thoracotomy patients. Oral opioid analgesics can manage pain, but they often cause side effects like nausea, sedation, and sleep disruption, which can worsen postoperative recovery. General anesthesia is used during surgery but has no role in managing postoperative pain or improving sleep afterward. It does not contribute to nighttime pain relief once the patient is in recovery.
Learn more about epidural injections.
For a patient requiring a minimal hospital stay and quick postoperative recovery, single-injection nerve blocks are often the preferred pain management strategy. These blocks provide effective, targeted pain relief with a rapid onset and are simple to administer, making them ideal for shorter or less complex surgical procedures. Their use has been associated with reduced opioid consumption, quicker mobilization, and high patient satisfaction — factors critical for fast recovery and early discharge. The major limitation to single-injection nerve blocks is the duration of analgesia, typically lasting less than 24 hours. Peripheral nerve blocks and neuraxial blocks are a few types of single-injection nerve blocks commonly used. Continuous catheter techniques are more invasive, require careful monitoring, and carry risks such as infection, catheter displacement, or pump malfunction. These factors can delay discharge and complicate recovery, making them less ideal for rapid recovery cases. Oral analgesics may not provide adequate pain control on their own, especially immediately after surgery. Insufficient pain management can hinder mobility and prolong hospital stay. Multiple-injection nerve blocks are not usually used, instead single-injection nerve blocks are recommended for quick postoperative recovery.
Learn more about local and regional anesthesia.
A primary benefit of continuous catheter techniques over single-injection nerve blocks for postoperative pain management is that they offer prolonged analgesia, which enhances patient comfort and reduces the need for additional analgesics. Unlike single-injection blocks that wear off within hours, continuous catheter methods — such as continuous peripheral nerve blocks or epidural analgesia — provide sustained pain relief for 2-3 days. This extended duration allows for better pain control, supports early mobilization, and lowers reliance on opioids, ultimately improving recovery outcomes and patient satisfaction. Catheter techniques actually require more monitoring due to risks like infection, catheter displacement, or pump malfunction. Continuous nerve catheters can be used in ambulatory surgery with the evolution of local anesthetic delivery systems and pumps and even in outpatient procedures. While effective, continuous catheter techniques may carry higher complication risks related to catheter management, such as infections or technical failures. Thus, their key advantage lies in providing extended, consistent pain control for patients with significant postoperative pain needs.
Learn more about catheter techniques.
Nondrug pain management encompasses a range of physical, psychological, and sensory interventions that provide effective, low-risk alternatives to medications. Although effectiveness varies between individuals, TENS can provide pain relief, is noninvasive, and cost-effective. Heat therapy can also relieve muscle tension and pain and improve blood flow, but it can cause burns if used improperly. Cryotherapy can also reduce pain and inflammation, although it can sometimes impair healing and is not suitable for everyone. Cryotherapy can limit blood flow, reduce the delivery of healing agents to the affected area, and cause tissue necrosis or nerve impairment. Individual responses to aromatherapy vary widely, and clinical evidence supporting its effectiveness remains limited.
Learn more about heat and cold therapies.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
an hour ago
- Yahoo
Jerry Jones reveals 2010 cancer diagnosis in new documentary
Jerry Jones reveals he battled cancer in an upcoming Netflix documentary series about the Dallas Cowboys. In an episode of "America's Team: The Gamble and His Cowboys," the 10-part documentary series scheduled to premier next Tuesday, Jones mentions that he underwent cancer treatment "about a dozen years ago." On Wednesday morning, the Dallas Morning News reported that Jones overcame stage 4 melanoma after a decade-long battle beginning with his diagnosis in 2010. "I was saved by a fabulous treatment and great doctors and a real miracle [drug] called PD-1 [therapy]," Jones told the Dallas Morning News. "I went into trials for that PD-1 and it has been one of the great medicines. "I now have no tumors." REVIEW: 'America's Team' Netflix series a fascinating look at Jerry Jones, Cowboys According to the American Cancer Society, PD-1 therapy targets the PD-1 protein on immune cells. PD-1 is a "checkpoint protein" that can prevent immune cells called "T cells" from attacking normal cells. However, some cancer cells have enough of PDL-1, a different protein that bonds with PD-1 and allows it to prevent attacks from the immune system. The goal of checkpoint protein-related therapy is to block PD-1 from bonding with PDL-1, essentially allowing the body's immune system to attack other cells more freely. The aim is to "help the immune system to better find and attack the cancer cells, wherever they are in the body," but it can lead to some brutal side effects as the immune system might attack other, healthy cells in the body. Jones' stage 4 cancer diagnosis means that the cancer cells from his melanoma had spread to other parts of his body, which is what led to his four surgeries surgeries on his lungs and lymph nodes. According to the American Cancer Society, melanoma patients who have had their cancer metastasize to "distant parts of the body, such as the lungs, liver, or skin, or lymph nodes" have a five-year survival rate of 35%. Jones was one of the fortunate survivors of his battle. This article originally appeared on USA TODAY: Cowboys documentary reveals Jerry Jones' cancer diagnosis in 2010
Yahoo
an hour ago
- Yahoo
Remember ‘The Biggest Loser'? A new docuseries explores the harm the show did in the name of health
Millions of Americans watched for 18 seasons as people pushed their bodies to the limits physically, ate as few calories as possible, and underwent sometimes mortifying challenges to be crowned 'The Biggest Loser.' It was discomfort worth grappling with for a shot at better health and a new life, many of the contestants said. But 'Fit for TV: The Reality of 'The Biggest Loser,'' a Netflix docuseries premiering Friday, suggests that the cultural phenomenon may not have been healthy for the contestants or the country at large. When creating the new show, filmmakers asked themselves whether 'The Biggest Loser' was, in fact, part of an industry promoting health and wellness in the United States, said Skye Borgman, the director of the docuseries. 'Everybody always wants a magic bullet that's real. And the thing about magic bullets — they're never real.' 'Fit for TV: The Reality of 'The Biggest Loser'' investigates how the highly popular show affected the contestants and conversations around health. The docuseries also explores the implications of so many viewers being willing to watch –– and sometimes laugh at –– people attempting to lose weight. 'It was such a huge phenomenon and absolutely reflected and perpetuated some of the really harmful messages around weight and weight loss,' said Dr. Rebecca Pearl, associate professor of clinical and health psychology at the University of Florida. Promoting health or harm? In a show claiming to transform people's health, what did the contestants' regimens look like? Men were advised to cut their calories down to 1,500 to 2,000 per day and women to 1,200 per day, said Dr. Robert Huizenga, physician on 'The Biggest Loser,' in the series. But sometimes, trainers might have recommended as few as 800 calories daily, he added. The amount of exercise was also intense, sometimes spanning eight hours a day, former contestant Danny Cahill said in the docuseries. The series showed clips of contestants dropping to the floor from a treadmill run, many people vomiting in the gym, and instances when caffeine pills were utilized to curb appetite. 'There's not any way that an entertaining show and a health show can 100% exist together. … One of them is always going to take the lead,' Borgman said. 'In the case of 'The Biggest Loser,' I feel like the entertainment value of the show far outran the health aspects of the show.' An extreme diet and exercise regimen is associated with significant health risks, Pearl said. Losing too much weight too quickly or not getting enough calories can lead to gallbladder complications, muscle loss and nutritional deficits, she said. Overexercising can result in heart problems, dehydration and injury –– which also prevents people from maintaining healthy behaviors. Eating a balanced diet and getting movement in your day is generally good for health, but the punishing approach to food and exercise showcased on 'The Biggest Loser' also worked against long-term health-promoting activities, Pearl added. 'One predictor and one recommendation for engaging in physical activity long term is to find an activity you enjoy,' she said. 'The kind of grueling, suffering activity that was shown on that show is not setting someone up to build a healthy, positive relationship with physical activity or with their body.' When the weight comes back One theme that may have kept viewers coming back to the show was the hope that someone could make a dramatic, lasting change to their body. But a weight loss transformation that stood the test of time wasn't always necessarily the result even in 'The Biggest Loser,' Borgman said. A 2017 study following 14 contestants in the years after 'The Biggest Loser' wrapped found that many regained much or all the weight they had lost over the course of the show. The return of the weight makes sense, said Dr. Larissa McGarrity, clinical psychologist in physical medicine and rehabilitation at University of Utah Health. The degree of calorie restriction and intensity of exercise were at levels that neither the contestants nor the viewers could implement at home in a realistic way, she said. Also, the amount of weight lost from week to week was extreme. At times, show participants were losing up to double digits at each weekly weigh in. Experts tend to recommend a sustainable weight loss rate of 1 to 2 pounds per week, McGarrity said — adding that the best guidance is to utilize the methods you can keep up long-term. 'The answer instead is probably, 'how do I slowly make changes in my life that help me to get in the right nutrients to help my body feel good? How do I move in a way that will allow my body and mind to feel at its best over time?'' she said. 'Making too many changes at once tends to not go well for most people from a psychological or behavioral standpoint.' Even if viewers at home could implement the stringent protocol followed by 'The Biggest Loser' contestants, research suggests metabolic changes from the dramatic weight loss depicted on the show made it harder to keep the weight off. Six years after contestants were on the show, the 14 studied on average still had a slower metabolisms, even if they had regained about two-thirds of the weight they had lost, according to the study. Their bodies were naturally burning fewer calories throughout the day and increasing hunger cues. 'It essentially means that keeping the weight off long term is nearly impossible without continued extreme measures over many years, because your body will fight against you to maintain that weight or defend that weight at that initially higher level,' McGarrity said. Laughing at fatness Often interwoven into 'The Biggest Loser' –– from coaches, in depictions of bodies, and in the audience interactions –– was a lot of shame, McGarrity said. The format supported a myth around weight: that the size of a person's body is totally under their control, and having a larger body is a sign of lack of willpower or moral failing, she said. That myth ignores the realities of things like genetics, environment and individual metabolisms, and it paves the way for denigration and callousness, she said. 'Cruelty, verbal abuse, sort of indirect physical abuse, in terms of being forced to really torture your body in unhealthy ways –– there was a sense that if you're in a larger body, you deserve this,' said Oona Hanson, a parent coach who specializes in helping families navigate diet culture and eating disorders. 'It made us participate as viewers in kind of like a pity or even disgust response in terms of the way people's bodies were portrayed, in the way they talked about their bodies,' she added. The docuseries showed just how dehumanizing or degrading those images could be, with cameras shaking as contestants fell to make it look like they caused an earthquake or challenges asking contestants to carry whole loaves of bread in their mouths. 'Without really being completely aware of it, the show succeeded in making fun of fat people,' Borgman said. Some contestants did say that they found empowerment and representation in being part of a competition in which they succeeded in goals and accomplished physical feats, she added. But it isn't hard to find a clip from 'The Biggest Loser' in which contestants are put in disparaging situations, Pearl added. Content that stigmatizes the size of a person's body and emphasizes thinness at all costs impacts not just the contestants, but also the viewers at home, Hanson said. It's hard for those viewers not to internalize those negative stereotypes, affecting how people see their communities and themselves. 'The Biggest Loser' may have been canceled years ago, but 'Fit for TV' shares that the reality show's lasting influence underscores the fact that the United States has not elevated the way people talk about weight and bodies, Borgman added. 'We as a culture feel like we're super evolved. … We don't judge. We take people for who they are,' she said. 'I don't think that's true at all. So, I hope people walk away from this series and look at themselves a little bit more and how we treat people.' Get inspired by a weekly roundup on living well, made simple. Sign up for CNN's Life, But Better newsletter for information and tools designed to improve your well-being.
Yahoo
an hour ago
- Yahoo
Reduced capacity at health centre in Pelly Crossing, Yukon, until early September
The health centre in Pelly Crossing, Yukon, will be operating at reduced capacity until Sept. 3, while it only has one nurse on staff. In a Facebook post on Thursday, Selkirk First Nation informed its citizens that the health centre would have reduced services from Aug. 14 to Sept. 3, sharing a notice from the Yukon government. Nigel Allan with Yukon Health and Social Services said the nurse will prioritize emergencies during this time. Non-urgent health care needs, like preventative care or other things that can wait, might need to be rescheduled he said. The reduction in services comes on the heels of a week of reduced service earlier this month when the centre was also operating with only one nurse. The health centre was also closed for several weeks in the spring, and for a day-and-a-half last winter, because no nurses were available. Allan said the Yukon, like many other places in Canada is "dealing with a health HR crisis." "As part of our health HR strategy, we're continuing efforts to recruit health-care providers, including nurses." Allan said nurses working in community health centres often need specialized training to respond to urgent situations, which can make it harder to recruit them. The Yukon government's notice says in emergencies, Pelly residents can call 867-821-444, use the phone outside the health centre or dial 911. For non-emergencies, they can call 811.
