Acute Pain in Emergency Surgery: A Call for More Precise Patient-Centered Approaches
DOI:
https://doi.org/10.68041/anjmls.v1i3/01Keywords:
Acute pain, Pain Management, Multimodal analgesia, Emergency Surgery, Patient-Centered CareAbstract
The development of emergency surgical care has improved clinical outcomes, and the mortality rate has been reduced by a great margin, but the management of acute pain remains one of the biggest problems. Acute pain in post-emergency surgical patients is often not well identified, evaluated, and treated, which contributes to the prolonged period of recovery, greater complications, and poor patient satisfaction. There is evidence to indicate that inadequately managed postoperative pain can be one of the contributing factors to delayed mobilization, psychological distress, and functional impairment in the long term. This paper will review the current literature on acute pain in emergency surgery, its prevalence, factors contributing to it, available management protocols, pain evaluation procedures, drug and non-drug interventions, and patient-reported measures. The literature indicated that pain management practices vary significantly, the use of standardized pain assessment tools is limited, and incorporation of patient-centered approaches is also inadequate. It is necessary to involve accurate pain evaluation, multimodal analgesia, case-specific care plans, and sustained pain management after the immediate postoperative phase to enhance acute pain outcomes of emergency surgery, improve recovery, and quality of care.
References
1. Rech MA, Griggs C, Lovett S, Motov S. Acute pain management in the Emergency Department: Use of multimodal and non-opioid analgesic treatment strategies. Am J Emerg Med. 2022;58:57-65. https://doi.org/10.1016/j.ajem.2022.05.022 DOI: https://doi.org/10.1016/j.ajem.2022.05.022
2. Zanza C, Romenskaya T, Zuliani M, Piccolella F, Bottinelli M, Caputo G, Rocca E, Maconi A, Savioli G, Longhitano Y. Acute Traumatic Pain in the Emergency Department. Diseases. 2023;11(1):45. https://doi.org/10.3390/diseases11010045 DOI: https://doi.org/10.3390/diseases11010045
3. Yunus AA, Ugwu EM, Ali Y, Olagunju G. Postoperative Pain Management in Emergency Surgeries: A One-year Survey on Perception and Satisfaction among Surgical Patients. Niger J Surg. 2020 Jan-Jun;26(1):42-47. https://doi.org/10.4103/njs.NJS_18_19 DOI: https://doi.org/10.4103/njs.NJS_18_19
4. Kim SJ, Park K, Kim K. Post-intensive care syndrome and health-related quality of life in long-term survivors of intensive care unit. Aust Crit Care. 2023;36(4):477-484. https://doi.org/10.1016/j.aucc.2022.06.002 DOI: https://doi.org/10.1016/j.aucc.2022.06.002
5. Collet MO, Egerod I, Thomsen T, Wetterslev J, Lange T, Ebdrup BH, et al. Risk factors for long-term cognitive impairment in ICU survivors: A multicenter, prospective cohort study. Acta Anaesthesiol Scand. 2021 Jan;65(1):92-99. https://doi.org/10.1111/aas.13692 DOI: https://doi.org/10.1111/aas.13692
6. Teixeira C, Rosa RG, Sganzerla D, Sanchez EC, Robinson CC, Dietrich C, et al. The Burden of Mental Illness Among Survivors of Critical Care-Risk Factors and Impact on Quality of Life: A Multicenter Prospective Cohort Study. Chest. 2021;160(1):157-164. https://doi.org/10.1016/j.chest.2021.02.034 DOI: https://doi.org/10.1016/j.chest.2021.02.034
7. Ahn S, LaNoue M, Su H, Moale AC, Scheunemann LP, Kiehl AL, et al. Post-Intensive Care Syndrome and Caregiver Burden: A Post Hoc Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2025;8(4):e253443. https://doi.org/10.1001/jamanetworkopen.2025.3443 DOI: https://doi.org/10.1001/jamanetworkopen.2025.3443
8. Khurrum M, Asmar S, Joseph B. Telemedicine in the ICU: Innovation in the Critical Care Process. J Intensive Care Med. 2021 Dec;36(12):1377-1384. https://doi.org/10.1177/0885066620968518 DOI: https://doi.org/10.1177/0885066620968518
9. Nakanishi N, Liu K, Hatakeyama J, Kawauchi A, Yoshida M, Sumita H, et al. Post-intensive care syndrome follow-up system after hospital discharge: a narrative review. J Intensive Care. 2024;12(1):2. https://doi.org/10.1186/s40560-023-00716-w DOI: https://doi.org/10.1186/s40560-023-00716-w
10. Kehlet H, Dahl JB. The value of multimodal or balanced analgesia in postoperative pain treatment. Anesth Analg. 1993;77(5):1048–1056. https://doi.org/10.1213/00000539-199311000-00030 DOI: https://doi.org/10.1213/00000539-199311000-00030
11. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society. J Pain. 2016;17(2):131–157. https://doi.org/10.1016/j.jpain.2015.12.008 DOI: https://doi.org/10.1016/j.jpain.2015.10.023
12. Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of postsurgical pain: results from a US national survey. Curr Med Res Opin. 2014;30(1):149–160. https://doi.org/10.1185/03007995.2013.860019 DOI: https://doi.org/10.1185/03007995.2013.860019
13. Rawal N. Current issues in postoperative pain management. Eur J Anaesthesiol. 2016 Mar;33(3):160–171. https://doi.org/10.1097/EJA.0000000000000366 DOI: https://doi.org/10.1097/EJA.0000000000000366
14. Hachimi-Idrissi S, Coffey F, Hautz WE, Leach R, Sauter TC, Sforzi I, et al. Approaching acute pain in emergency settings: European Society for Emergency Medicine (EUSEM) guidelines—part 1: assessment. Intern Emerg Med. 2020;15(7):1125-39. https://doi.org/10.1007/s11739-020-02477-y DOI: https://doi.org/10.1007/s11739-020-02477-y
15. Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med. 2010;11(12):1859–1871. https://doi.org/10.1111/j.1526-4637.2010.00983.x DOI: https://doi.org/10.1111/j.1526-4637.2010.00983.x
16. Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. The Lancet. 2003;362(9399):1921–1928. https://doi.org/10.1016/S0140-6736(03)13540-2 DOI: https://doi.org/10.1016/S0140-6736(03)14966-5
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