The established approach to postoperative pain is to combine non-opioid analgesics, such as paracetamol and a non-steroidal anti-inflammatory drug where there is no contraindication, with regional or local anaesthetic techniques where suitable, and to keep opioids for breakthrough pain. The aim is to improve analgesia while reducing opioid dose and its side effects.
Plan this before surgery, check contraindications for each agent, and agree with the surgical team what the patient will go home on and for how long.
- Plan analgesia before surgery, including what the patient will take at home.
- Check renal function, bleeding risk and cardiovascular history before an anti-inflammatory drug.
- Use regional or local techniques where suitable.
- Keep opioids for breakthrough pain and give a clear stopping plan.
Why it matters
A plan made before surgery avoids reaching for opioids by default.
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