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This article reviews aspects of postoperative and chronic pain management in urology patients. Continuous epidural techniques are recommended for extensive retroperitoneal und transperitoneal surgery due to its excellent analgesia and facilitation of enhanced recovery. In patients without regional analgesia techniques, intravenous or oral non-opioid analgesics should be combined with titration of fast acting opioids on an as-needed basis. Oral slow-release opioids are increasingly being used as part of systemic pain management although little evidence exists. Local wound infiltration and transcutaneous electrical nerve stimulation (TENS) treatment are simple and effective supplements for postoperative pain management. In 70-90% of urological cancer patients pain can be adequately relieved by consistent adherence to the WHO cancer pain recommendations. Additional pain relief approaches, such as radiation as well as psychosocial and spiritual needs of these patients have to be considered. In long-term treatment of non-cancer pain, effective use of opioids is not evidence-based. These patients often benefit from multimodal, interdisciplinary pain management comprising psychological and educational approaches as well as activating physiotherapy.
Klinik für Anästhesiologie und Intensivtherapie, Erlanger Allee 101, 07747, Jena, Deutschland, Annette.Zimmer@med.uni-jena.de.
This article was published in the following journal.
Name: Der Urologe. Ausg. A
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A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.
Participation of employees with management as a labor-management team, in decisions pertaining to the operational activities of the organization or industry.
The management of all procurement, distribution, and storage of equipment and supplies, as well as logistics management including laundry, processing of reusables, etc.
Business management of medical and dental practices that may include capital financing, utilization management, and arrangement of capitation agreements with other parties.
Management review designed to evaluate efficiency and to identify areas in need of management improvement within the institution in order to ensure effectiveness in meeting organizational goals.
Neurology - Central Nervous System (CNS)
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