Perioperative Pain Management Using Local and Regional Analgesia for Cardiothoracic Surgeries, Mastectomy, and Abdominal Surgeries in Adults and Children

- Implementation Considerations

-    Pain intensity can be assessed using various tools, e.g., visual analog scales, numerical rating scales, or ordinal scales. Resting and dynamic pain can be measured.

-    Reporting important patient-oriented outcomes, such as quality of recovery, patient satisfaction with pain management, and harms are important. The outcomes should include both unidimensional and multidimensional assessments, as pain affects various aspects of daily life, such as function, sleep, emotions, and other activities and cannot be fully captured by assessment of pain intensity within a single time point or interval.

-    Resolution of moderate to severe pain after surgery, which limits mobility and other rehabilitative goals, can last several days to weeks based on the patient and procedure.

-    Fascial plane blocks are strongly recommended for adults undergoing open cardiothoracic, mastectomy, abdominal, retroperitoneal, pelvic surgeries, and minimally invasive abdominal procedures.

-    Fascial plane blocks are strongly recommended for children undergoing open cardiac or thoracic surgeries and are conditionally recommended for children undergoing open hernia repair.