الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
SUMMARY
T
he goal in postoperative pain management is to mobilize the person as early as possible, get them eating and drinking as early as appropriate and ensure they are able to cough and breathe. Therefore, if patients are not given good postoperative pain management they have an increased risk of chest infections, hypoxia and cardiac problems, pressure sores, deep vein thrombosis, depression, anxiety, anorexia, increased wound infection rates, etc.
Anaesthesia for total hip and knee arthroplasty should provide stable intra-operative conditions and allow rapid patient recovery. Analgesic techniques should aim to provide optimal pain relief whilst minimizing side effects such as sedation, PONV, hypotension, and motor block. There is now good evidence that well-conducted regional analgesia can achieve these aims, leading to improved functional recovery facilitated by more rapid and effective joint rehabilitation.
Opioids remain the mainstay of systemic analgesia for the treatment of moderate to severe acute pain. After operative fracture treatment, patients who take more opioids report greater pain intensity and less satisfaction with pain relief. Greater self-efficacy was the best determinant of satisfaction with pain relief. Evidence-based interventions to increase self-efficacy merit additional study for the management of postoperative pain during recovery from a fracture.
Morphine remains the most widely used opioid for the management of pain and the standard against which other opioids are compared.
The consistent efficacy of epidural analgesia has been well demonstrated. Regardless of analgesic agent used, location of catheter, type of surgery and type or time of pain assessment, it provided better pain relief than parenteral opioid administration