Mostpatients whoundergosurgicalproceduresexperience acutepostoperativepain, butev-idence suggests that less than half report adequate postoperative pain relief. Many preoperative, intra-operative, and postoperative interventions and management strategies are available for reducing andmanaging postoperative pain. The American Pain Society, with input from the American Society of Anes-thesiologists, commissioned an interdisciplinary expert panel to develop a clinical practice guideline topromote evidence-based, effective, and safer postoperative pain management in children and adults.The guideline was subsequently approved by the American Society for Regional Anesthesia. As part ofthe guideline development process, a systematic review was commissioned on various aspects relatedto various interventions and management strategies for postoperative pain. After a review of the evi-dence, the expert panel formulated recommendations that addressed various aspects of postoperativepain management, including preoperative education, perioperative pain management planning, use ofdifferent pharmacological and nonpharmacological modalities, organizational policies, and transitiontooutpatientcare.Therecommendationsarebasedontheunderlyingpremisethatoptimalmanagementbegins in the preoperative period with an assessment of the patient and development of a plan of caretailored to the individual and the surgical procedure involved. The panel found that evidence supportsthe use of multimodal regimens in many situations, although the exact components of effective multi-modal care will vary depending on the patient, setting, and surgical procedure. Although these guide-lines are based on a systematic review of the evidence on management of postoperative pain, thepanel identified numerous research gaps. Of 32 recommendations, 4 were assessed as being supportedby high-quality evidence, and 11 (in the areas of patient education and perioperative planning, patientassessment, organizational structures and policies, and transitioning to outpatient care) were made onthe basis of low-quality evidence.

Perspective:This guideline, on the basis of a systematic review of the evidence on postoperative painmanagement, provides recommendations developed by a multidisciplinary expert panel. Safe and effec-tive postoperative pain management should be on the basis of a plan of care tailored to the individual andthe surgical procedure involved, and multimodal regimens are recommended in many situations.

大多数接受外科治疗的患者发生急性术后疼痛，但只有不到一半的患者报告术后疼痛得到充分缓解。许多术前、术中和术后干预和管理策略可用于减少和管理术后疼痛。美国疼痛学会在美国麻醉医师学会的支持下，委托跨学科专家小组制定临床实践指南，以促进儿童和成人术后疼痛的循证、有效和更安全的管理。该指南随后得到了美国区域麻醉学会的批准。作为指南制定过程的一部分，委托对与术后疼痛的各种干预和管理策略相关的各个方面进行了系统综述。在回顾了该事件后，专家小组提出了建议，涉及术后管理的各个方面，包括术前教育、围手术期疼痛管理计划、使用不同的药理学和非药理学方式、组织政策和过渡到门诊治疗。治疗决策是基于术前的前提进行最佳治疗，对患者进行评估，并制定针对个体和所涉及的外科手术的护理计划。专家小组发现，证据支持在许多情况下使用多模式治疗方案，尽管有效多模式治疗的确切组成部分将因患者、环境和外科手术而异。尽管这些指南是基于对术后疼痛管理证据的系统综述，thepanel确定了许多研究差距。在32项建议中，4项被评估为由高质量证据支持，11项（在患者教育和围手术期计划、患者评估、组织结构和政策以及过渡到门诊护理领域）是在低质量证据的基础上提出的。

视角：本指南基于对术后疼痛管理证据的系统综述，提供了由多学科专家小组制定的建议。安全有效的术后疼痛管理应基于针对个体和所涉及的手术程序制定的护理计划，在许多情况下推荐多模式方案。