A systems approach to perioperative pain management

The current crisis of opioid addiction has shed light on the shortcomings of our historically fragmented and arbitrary approaches to perioperative pain management. Effective perioperative pain management is multifactorial and can be enhanced via a systems-based approach that spans the continuum of the perioperative encounter. Key elements of a systems approach include preoperative pain management assessment and education, utilization of multimodal analgesia, strong collaboration with anesthesia providers and perioperative nursing professionals, and establishing postdischarge support and communication processes for patients. Although relatively novel, enhanced recovery protocols-based on the broader concept of enhanced recovery after surgery (ERAS)-have shown great promise and are efficacious models of systems-based perioperative pain management.