Why has postoperative pain been undertreated in the past?

Why has postoperative pain been undertreated in the past?

Despite  tremendous  advances  in  medications,  techniques, knowledge, and education about pain, both acute and chronic pain are still tremendously undertreated throughout the world. Because of undertreatment of both acute and chronic pain in the hospitalized patient in the United States, Joint Commission on the Accreditation of Hospital Organizations (JCAHO) has mandated that the patient’s pain be assessed and treated, and both patients and hospital staff be educated about the modalities of pain therapies available.

Postoperative pain, in particular, has been undertreated in both the ambulatory and inpatient settings. Misconceptions about the pharmacokinetics and pharmacodynamics of anal-gesic medications, fear of opioid side-effects, and the histori-cal use of unpredictable intramuscular administration of opioids have all led to undertreatment of pain in the post-operative setting. Other barriers which need to be broken include the misconception of a “standard” dose of an anal-gesic to control pain in all patients. Current theory states that individual titration is the best way to safely and effectively promote analgesia. It must also be recognized that one can-not judge another person’s level of pain; the patient must be integrated into the process and rate his or her own pain.