Ambulatory surgery acute pain management: A review of the evidence

The purpose of this review is to examine the evidence for postoperative analgesic techniques in ambulatory surgery. A search was performed using the title and text words ambulatory surgical procedures and postoperative pain to identify relevant publications on Medline, The Cochrane Library and Embase Anesthesiology Database. The review assesses and compares benefits of local anaesthetic techniques, including local infiltration, intravenous regional anaesthesia, intra-articular anaesthesia, neuraxial block, peripheral nerve block, and continuous infusions. It examines types of peripheral nerve blockade pertinent to ambulatory surgery and indications for its use. It outlines current spinal anaesthesia controversies in ambulatory surgery including transient neurological symptoms and discharge criteria. It examines the role of opioids, non-steroidal-antiinflammatory drugs and non-pharmacological techniques in the management of postoperative pain in ambulatory surgery with a recommended pain management plan.