Multimodal management of postoperative pain in abdominal surgery: a comparative analysis of the ERAS, APS, and PROSPECT guidelines

Introduction: a large majority of patients undergoing abdominal surgery experience pain, which can be attributed to poor management. This leads to a decreased quality of life, increased morbidity and mortality, prolonged hospital stays, and higher costs. Inadequate postoperative pain management remains a significant healthcare problem. Various strategies and protocols exist for controlling pain, but it is currently unclear which is most effective for these types of procedures. Methods: a research protocol is carried out for the subsequent preparation of a systematic review of the literature by collecting selected articles on scientific research platforms: PubMed, Embase, Scopus and Scielo in order to provide sustainable information about the application of multimodal protocols for the management of postoperative pain in adult patients undergoing abdominal surgery, evaluating and comparing the efficacy, safety and cost-benefit to improve the quality of care and clinical outcomes. Results: multimodal analgesia is gaining ground as a first-line strategy, but significant rates of poorly controlled pain persist. Population studies report between 30 % and 75 % of patients with moderate to severe postoperative pain. This leads to limitations in early mobilization and postoperative rehabilitation, and increases the incidence of respiratory, gastrointestinal, and cardiovascular complications. Conclusion: the management of acute postoperative pain remains a challenge in today’s world. Many patients report moderate to severe pain after abdominal surgery, which can lead to chronic pain. Further studies are needed to establish an appropriate protocol and identify the factors that limit its implementation.