Pain control in the postoperative cardiac surgery patient

Physiologic changes occurring as a result of both stress and surgery may be detrimental to the postoperative cardiac surgery patient. Pain and its accompanying stress response can be successfully reduced with adequate analgesia. In the early postoperative period, intravenous opioids are most commonly used. Later, parenteral opioids, nonopioid analgesics, and/or spinal opioids provide excellent analgesia and should be aggressively used. Post- CABG chronic pain syndromes can develop and must be treated early to optimize the likelihood of a successful treatment result. The most important element in the pain management of the perioperative cardiac surgical patient is adaptability. As with all other aspects of postoperative care, choice of analgesics and techniques for their administration need to be individualized. There is no magic cocktail.