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

Basic Principles and Terminology

The following definitions are used For the purposes of this guideline:

Dynamic pain: is defined as pain with cough or movement. It is pain triggered or severely worsened by by physical activity, movement, or pressure (also called movement-evoked pain).

Minimal Clinically Important Difference (MCID): refers to the smallest change in a treatment outcome or health score that a patient perceives as meaningful and beneficial. An MCID of 1 point means that a tiny shift of just one single point on a clinical rating scale (such as a 0–10 pain scale or symptom checklist) is enough to represent a real-world, noticeable difference in how a patient feels or functions.

Oral Morphine Equivalent (OME): is a standardized metric used to calculate and compare the potency of different opioid pain medications (e.g., oxycodone, hydrocodone, fentanyl) relative to oral morphine. 

Static pain (or pain at rest): pain felt when the body is completely still.

Truncal blocks: are regional anesthesia techniques where local anesthetics are injected into the chest, abdomen, or back to disrupt pain signaling from the T2 through L1 spinal nerves.