* Neuraxial or peripheral block with or without a catheter, wound infiltration, or wound infusion.
¶ The expected degree of pain and time course of resolution vary with both patient factors and the type of surgery, and may be difficult to predict. In general, peripheral superficial procedures (eg, carpal tunnel release) should result in mild pain of relatively short duration; moderate pain should be expected after most laparoscopic and other minimally invasive surgeries and most soft tissue surgeries; and severe pain occurs after major open surgery, spine surgery, and arthroplasty.
Δ Use of gabapentinoids for postoperative pain is controversial and practice varies. Consider gabapentinoids for patients <75 years of age who undergo moderately to severely painful surgery.
◊ Consider ketamine for patients who would benefit from maximal opioid avoidance (eg, patients who are opioid tolerant, with opioid use disorder, or who have obstructive sleep apnea).
§ Consider lidocaine for patients who undergo spine surgery or open abdominal surgery when epidural analgesia is not used.