Perioperative pain management in colorectal surgery

Perioperative pain control is an integral part of Enhanced Recovery After Surgery (ERAS) guideline. Advances in surgical technique, such as laparoscopic and robot-assisted colorectal surgery, reduce tissue trauma with an effect on analgesic requirements. While opioid therapy is still important for managing pain in colorectal surgery, it has undesirable side effects including delayed recovery of bowel function, respiratory depression, and postoperative nausea and vomiting. A variety of non-opioid systemic medical therapies as well as regional and neuraxial techniques have been described as a part of multimodal analgesia. This facilitates early mobilization, early return of bowel function and decreases postoperative morbidity. In this article, we examine multimodal therapies and their impact on postoperative analgesia and recovery for patients undergoing colorectal surgery.