J Korean Med Assoc.  2025 Jan;68(1):13-19. 10.5124/jkm5.2025.68.1.13.

Pain management strategies for abdominal surgery

• Song SW
• Park JH

• KMID: 2564283
• DOI: http://doi.org/10.5124/jkm5.2025.68.1.13

Abstract

Background
Effective pain management after abdominal surgery enhances recovery, improves patient satisfaction, and reduces complications. Despite advancements in surgical techniques and recovery protocols, moderate to severe postoperative pain affects up to 55% of patients, leading to delayed recovery, increased opioid use, dependency, and persistent pain. Multimodal analgesia, a core component of enhanced recovery protocols, aims to minimize stress responses, optimize pain relief, and accelerate functional recovery.
Current Concepts
Opioids remain pivotal in perioperative pain management due to their effectiveness and adaptability but carry significant side effects, including respiratory depression, opioid-induced hyperalgesia, and potential oncological implications. Systemic analgesics, such as glucocorticoids, NSAIDs, and gabapentinoids, complement opioids but have limited efficacy and adverse effects. Regional analgesia techniques—epidural blocks, transversus abdominis plane (TAP) blocks, erector spinae plane blocks, and quadratus lumborum (QL) blocks—are increasingly important. These methods provide targeted pain relief, reduce opioid requirements, and facilitate recovery, particularly when tailored to specific surgeries.
Discussion and Conclusion
Regional anesthesia effectively controls pain, reduces opioid-related complications, and promotes early ambulation. TAP and QL blocks are particularly advantageous for abdominal surgery, reducing pain and opioid use. However, technical challenges and outcome variability necessitate careful patient selection and skilled execution. Optimizing multimodal analgesia through personalized strategies and ongoing research is essential for improving postoperative care.

Keyword

Surgery; Imported parasitic diseases; Malaria; Analgesia; Postoperative care; Leishmaniasis; Schistosomiasis; Enhanced recovery after surgery; Hydatid disease; Pain management; 수술; Korea; 진통; 수입 기생충 질환; 수술 후 관리; 말라리아; 수술 후 회복 향상; 리슈만편모충증; 통증조절; 주혈흡충증; 포충병; 한국