Perioperative Education and Rehabilitation and Its Effects on Pain

摘要

The primary objective of perioperative pain management is to alter the physiologic reaction to pain by interrupting pain perception mechanisms. Pain control addresses directly preventing the initial pain response in the perioperative period. Perioperative pain management principles apply to the preoperative, intraoperative, and postoperative periods. Preoperative treatment prepares the patient for surgery and recovery and addresses the localized inflammatory response. Preoperative patient instruction should include information about pain medications, complication risks and their signals, expectations after surgery, early controlled motion, and gait. Goals after surgery are to control and abolish soft tissue inflammation and pain, restore active and passive ROM, and to increase muscular strength and endurance. Cryotherapy modalities and early muscular activity increased ROM and strength, decrease pain, and promote an early return to normal function. Other therapeutic techniques can decrease muscle spasm and aid in the prevention of random collagen adhesion formation, such as manual therapy to address flexibility and extensibility of soft tissue. The successful management of perioperative pain depends on a combination of rehabilitative techniques and information from the entire health care team; physician, registered nurse, and rehabilitation specialists. All of these team members must address patient fears, anxiety, and pain to return the patient to full function. Patient understanding of early goals and healing principles, in combination with rehabilitation compliance, is crucial for a successful outcome.