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World Journal of Emergency Surgery
Published in: World Journal of Emergency Surgery 1/2022

Open Access 01-12-2022 | Postoperative Pain Management | Review

Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines

Authors: Federico Coccolini, Francesco Corradi, Massimo Sartelli, Raul Coimbra, Igor A. Kryvoruchko, Ari Leppaniemi, Krstina Doklestic, Elena Bignami, Giandomenico Biancofiore, Miklosh Bala, Ceresoli Marco, Dimitris Damaskos, Walt L. Biffl, Paola Fugazzola, Domenico Santonastaso, Vanni Agnoletti, Catia Sbarbaro, Mirco Nacoti, Timothy C. Hardcastle, Diego Mariani, Belinda De Simone, Matti Tolonen, Chad Ball, Mauro Podda, Isidoro Di Carlo, Salomone Di Saverio, Pradeep Navsaria, Luigi Bonavina, Fikri Abu-Zidan, Kjetil Soreide, Gustavo P. Fraga, Vanessa Henriques Carvalho, Sergio Faria Batista, Andreas Hecker, Alessandro Cucchetti, Giorgio Ercolani, Dario Tartaglia, Joseph M. Galante, Imtiaz Wani, Hayato Kurihara, Edward Tan, Andrey Litvin, Rita Maria Melotti, Gabriele Sganga, Tamara Zoro, Alessandro Isirdi, Nicola De’Angelis, Dieter G. Weber, Adrien M. Hodonou, Richard tenBroek, Dario Parini, Jim Khan, Giovanni Sbrana, Carlo Coniglio, Antonino Giarratano, Angelo Gratarola, Claudia Zaghi, Oreste Romeo, Michael Kelly, Francesco Forfori, Massimo Chiarugi, Ernest E. Moore, Fausto Catena, Manu L. N. G. Malbrain

Published in: World Journal of Emergency Surgery | Issue 1/2022

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Abstract

Background

Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team.

Material and methods

An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript.

Conclusion

Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.
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Metadata
Title
Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines
Authors
Federico Coccolini
Francesco Corradi
Massimo Sartelli
Raul Coimbra
Igor A. Kryvoruchko
Ari Leppaniemi
Krstina Doklestic
Elena Bignami
Giandomenico Biancofiore
Miklosh Bala
Ceresoli Marco
Dimitris Damaskos
Walt L. Biffl
Paola Fugazzola
Domenico Santonastaso
Vanni Agnoletti
Catia Sbarbaro
Mirco Nacoti
Timothy C. Hardcastle
Diego Mariani
Belinda De Simone
Matti Tolonen
Chad Ball
Mauro Podda
Isidoro Di Carlo
Salomone Di Saverio
Pradeep Navsaria
Luigi Bonavina
Fikri Abu-Zidan
Kjetil Soreide
Gustavo P. Fraga
Vanessa Henriques Carvalho
Sergio Faria Batista
Andreas Hecker
Alessandro Cucchetti
Giorgio Ercolani
Dario Tartaglia
Joseph M. Galante
Imtiaz Wani
Hayato Kurihara
Edward Tan
Andrey Litvin
Rita Maria Melotti
Gabriele Sganga
Tamara Zoro
Alessandro Isirdi
Nicola De’Angelis
Dieter G. Weber
Adrien M. Hodonou
Richard tenBroek
Dario Parini
Jim Khan
Giovanni Sbrana
Carlo Coniglio
Antonino Giarratano
Angelo Gratarola
Claudia Zaghi
Oreste Romeo
Michael Kelly
Francesco Forfori
Massimo Chiarugi
Ernest E. Moore
Fausto Catena
Manu L. N. G. Malbrain
Publication date
01-12-2022
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2022
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/s13017-022-00455-7

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