Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines
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...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-09-01
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| Series: | World Journal of Emergency Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13017-022-00455-7 |
| _version_ | 1798001642074800128 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Federico Coccolini |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T11:39:32Z |
| format | Article |
| id | doaj.art-d814a297032c4be8a58c5834c6fb7995 |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-04-11T11:39:32Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-d814a297032c4be8a58c5834c6fb79952022-12-22T04:25:52ZengBMCWorld Journal of Emergency Surgery1749-79222022-09-0117111510.1186/s13017-022-00455-7Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelinesFederico Coccolini0Francesco Corradi1Massimo Sartelli2Raul Coimbra3Igor A. Kryvoruchko4Ari Leppaniemi5Krstina Doklestic6Elena Bignami7Giandomenico Biancofiore8Miklosh Bala9Ceresoli Marco10Dimitris Damaskos11Walt L. Biffl12Paola Fugazzola13Domenico Santonastaso14Vanni Agnoletti15Catia Sbarbaro16Mirco Nacoti17Timothy C. Hardcastle18Diego Mariani19Belinda De Simone20Matti Tolonen21Chad Ball22Mauro Podda23Isidoro Di Carlo24Salomone Di Saverio25Pradeep Navsaria26Luigi Bonavina27Fikri Abu-Zidan28Kjetil Soreide29Gustavo P. Fraga30Vanessa Henriques Carvalho31Sergio Faria Batista32Andreas Hecker33Alessandro Cucchetti34Giorgio Ercolani35Dario Tartaglia36Joseph M. Galante37Imtiaz Wani38Hayato Kurihara39Edward Tan40Andrey Litvin41Rita Maria Melotti42Gabriele Sganga43Tamara Zoro44Alessandro Isirdi45Nicola De’Angelis46Dieter G. Weber47Adrien M. Hodonou48Richard tenBroek49Dario Parini50Jim Khan51Giovanni Sbrana52Carlo Coniglio53Antonino Giarratano54Angelo Gratarola55Claudia Zaghi56Oreste Romeo57Michael Kelly58Francesco Forfori59Massimo Chiarugi60Ernest E. Moore61Fausto Catena62Manu L. N. G. Malbrain63General, Emergency and Trauma Surgery Department, Pisa University HospitalICU Department, Pisa University HospitalGeneral Surgery Department, Macerata HospitalTrauma Surgery Department, Riverside University Health System Medical CenterDepartment of Surgery No2, Kharkiv National Medical UniversityGeneral Surgery Department, Helsinki University HospitalClinic of Emergency Surgery, University Clinical Center of SerbiaICU Department, Parma University HospitalTransplant ICU Department, Pisa University HospitalTrauma and Acute Care Surgery Unit Hadassah, Hebrew University Medical CenterGeneral Surgery Department, Monza University HospitalGeneral and Emergency Surgery, Royal Infirmary of EdinburghTrauma/Acute Care Surgery, Scripps Clinic Medical GroupGeneral Surgery Department, Pavia University HospitalICU Department, Bufalini HospitalICU Department, Bufalini HospitalICU Department, Pisa University HospitalICU Department Papa Giovanni XXIII HospitalTrauma and Burn Service, Inkosi Albert Luthuli Central HospitalGeneral Surgery Department, Legnano HospitalEmergency and Colorectal Surgery, Poissy and Saint Germain en Laye HospitalsEmergency Surgery, HUS Helsinki University Hospital, Meilahti Tower HospitalTrauma and Acute Care Surgery, Foothills Medical CenterDepartment of Surgical Science, University of CagliariGeneral Surgery, Cannizzaro University HospitalGeneral Surgery Department, San Benedetto del Tronto HospitalTrauma Center, Groote Schuur Hospital, University of Cape TownGeneral Surgery Department, San Donato HospitalDepartment of Surgery, College of Medicine and Health Sciences, United Arab Emirates UniversityDepartment of Gastrointestinal Surgery, Stavanger University Hospital, University of BergenDivision of Trauma Surgery, School of Medical Sciences, University of CampinasICU Department, School of Medical Sciences, University of CampinasAnesthesia Department, School of Medical SciencesGeneral Surgery, Giessen University HospitalDepartment of Medical and Surgical Sciences – DIMEC, Alma Mater Studiorum - University of Bologna, General Surgery of the Morgagni - Pierantoni HospitalDepartment of Medical and Surgical Sciences – DIMEC, Alma Mater Studiorum - University of Bologna, General Surgery of the Morgagni - Pierantoni HospitalGeneral, Emergency and Trauma Surgery Department, Pisa University HospitalGeneral Surgery Department, UCLA Davis University HospitalGeneral Surgery Department, Government Gousiua HospitalEmergency and Trauma Surgery Department, Milano University HospitalEmergency Department, Nijmegen HospitalDepartment of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical HospitalBologna UniversityFondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro CuoreICU Department, Pisa University HospitalICU Department, Pisa University HospitalService de Chirurgie Digestive Et Hépato-Bilio-Pancréatique, Hôpital Henri Mondor, Université Paris EstDepartment of General Surgery, Royal Perth HospitalFaculty of Medicine of Parakou, University of ParakouGeneral Surgery Department, Nijmegen HospitalGeneral Surgery Department, Santa Maria Della Misericordia HospitalUniversity of Portsmouth, Portsmouth Hospitals University NHS Trust UKICU-HEMS Department, Arezzo HospitalICU Department, Maggiore HospitalICU Department, P. Giaccone HospitalICU Department, San Martino HospitalGeneral, Emergency and Trauma Surgery Department, Vicenza HospitalTrauma and Surgical Critical Care, East Medical Center Drive, University of Michigan Health SystemDepartment of General Surgery, Albury HospitalICU Department, Pisa University HospitalGeneral, Emergency and Trauma Surgery Department, Pisa University HospitalE. Moore Shock and Trauma CentreGeneral, Emergency and Trauma Surgery Department, Bufalini HospitalFirst Department Anaesthesiology Intensive Therapy, Medical University LublinAbstract 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.https://doi.org/10.1186/s13017-022-00455-7MorbidityAcutePainTreatmentEmergencySurgery |
| spellingShingle | 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 Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines World Journal of Emergency Surgery Morbidity Acute Pain Treatment Emergency Surgery |
| title | Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines |
| title_full | Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines |
| title_fullStr | Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines |
| title_full_unstemmed | Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines |
| title_short | Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines |
| title_sort | postoperative pain management in non traumatic emergency general surgery wses gais siaarti aast guidelines |
| topic | Morbidity Acute Pain Treatment Emergency Surgery |
| url | https://doi.org/10.1186/s13017-022-00455-7 |
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