Table 1.

Clinical practice points and research agenda

Clinical practice points

• Timing of administration of pre-emptive analgesia is before the incision or surgery. Pre-emptive analgesia provides improved analgesia postoperatively compared with the identical analgesic treatment after incision or surgery.

• Multimodal analgesia allows for lower doses of any one medication to be used in combination, thus decreasing side effects.

• Preventive analgesia can be provided by an intervention given before or after incision and surgery, whether it be a placebo, no treatment, or analgesic treatment that reduces analgesic use or postoperative pain for a period longer than the duration of action for the intervention.

• Duration of treatment and effective analgesic regimens are the two important considerations in the administration of preventive analgesia.

Research agenda

• There is an urgent need for preventive analgesic research evaluating which analgesic regimens would decrease the phenomenon of hyperalgesia and pain after surgery most effectively, and the multimodal therapies that would decrease or prevent long-term pain after surgery.

• More research is required to improve postoperative pain control by preventive analgesia with the use of another treatment, such as peripheral nerve blocks focusing on duration of postoperative analgesia.