Postoperative pain therapy is very important for the patients because an insufficient pain control can cause several negative reactions and jeopardise the health of patients. Insufficient postoperative pain therapy can result in a surgical stress reaction, deep vein thrombosis, coronary ischaemia, pulmonary embolism, and poor wound healing. Due to pain the proper respiratory function may be deteriorated, leading to some pulmonary complications, such as atelectasis and pneumonia. Psychological consequences including anxiety and depression may also be encountered. Although acute postoperative pain management has improved significantly in the past decades, inadequate postoperative pain relief remains a worldwide problem. Therefore, some efforts are ongoing to improve postoperative pain management. This therapy including "old" modalities of intermittent analgesic administration via i.m, s.c., and i.v. injections, continuous i.v. infusion has been improved already long time ago by using the PCA (patient-controlled analgesia) modalities either by intravenous or epidural routes. If appropriate, peripheral nerve or neuraxial blocks may be also used. Nevertheless some new therapy modalities have been recently developed and are under investigations or are already established. They include continuous wound infiltration with a local anaesthetic using an elastomeric infusion pump, morphine sulfate sustained-release liposome epidural injection, and intranasal/inhalational administration of opioids.
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