ABSTRACT
This chapter reviews state of the art pain management as it pertains to ambulatory colorectal surgery. Pain is the most common cause of hospital admission, or a visit to the emergency room after discharge. Postoperative pain management actually begins preoperatively. There must be discussion between patient and caregiver as to their expectation for the relief of pain. Pain is a complex, multimodal/dimensional symptom, determined not only by the physical presence of tissue injury, and the resulting nociceptor injury, but also by prior experience, personal beliefs, motivations, and environment. The uni-dimensional scaling technique is the oldest form of a pain measurement tool. Pain is assessed before the operation or intervention and again immediately after the operation; it is subsequently measured at regular intervals. The chapter addresses the pharmacodynamics and pharmacology of the various drugs available to the clinician, and explores dosing schedules, routes of administration, side-effects, and metabolic pathways relevant to the clinician.
