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

The purpose of these practice guidelines is to provide evidence-based recommendations regarding the appropriate management of perioperative pain for Cardiothoracic Surgeries, Mastectomy, and Abdominal Surgeries in adults and children. The guidance focuses primarily on regional analgesia and surgical site local anesthetic infiltration techniques as a component of a multimodal analgesia regimen. These guidelines address approaches to minimizing the degree of postoperative pain and/or opioid requirements. The use of systemic analgesics that constitutes a crucial component of a multimodal analgesic technique for perioperative pain management is not addressed. The objective is to provide up-to-date information to guide practice that will enhance patient safety. Practice guidelines are systematically developed recommendations that assist anesthesiologists, patients, and their caregivers in making decisions about health care. These recommendations may be adopted, modified, or rejected according to clinical needs and constraints and are not intended to replace local institutional policies.

The intended patient population: the recommendations in this guideline are intended to be applied to patients of all ages undergoing open or minimally invasive elective or urgent abdominal, retroperitoneal, pelvic, intrathoracic, extra-thoracic, or cardiac surgeries associated with substantive opioid requirements. They are intended as a framework for reasonable and acceptable patient care and should be interpreted as such to allow for some degree of flexibility in different circumstances and according to local practice.