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SPECIALARTICLESPracticeGuidelinesforAcutePainManagementinthePerioperativeSettingAnUpdatedReportbytheAmericanSocietyofAnesthesiologistsTaskForceonAcutePainManagementPRACTICEGuidelinesaresystematicallydevelopedrec-ommendationsthatassistthepractitionerandpatientinmakingdecisionsabouthealthcare.Theserecommenda-tionsmaybeadopted,modified,orrejectedaccordingtoclinicalneedsandconstraintsandarenotintendedtoreplacelocalinstitutionalpolicies.Inaddition,PracticeGuidelinesde-velopedbytheAmericanSocietyofAnesthesiologists(ASA)arenotintendedasstandardsorabsoluterequirements,andtheirusecannotguaranteeanyspecificoutcome.PracticeGuidelinesaresubjecttorevisionaswarrantedbytheevolutionofmedicalknowledge,technology,andpractice.Theyprovidebasicrec-ommendationsthataresupportedbyasynthesisandanalysisofthecurrentliterature,expertandpractitioneropinion,openfo-rumcommentary,andclinicalfeasibilitydata.Thisdocumentupdatesthe“PracticeGuidelinesforAcutePainManagementinthePerioperativeSetting:AnUpdatedReportbytheAmericanSocietyofAnesthesiolo-gistsTaskForceonAcutePainManagement,”adoptedbytheASAin2003andpublishedin2004.*MethodologyA.DefinitionofAcutePainManagementinthePerioperativeSettingFortheseGuidelines,acutepainisdefinedaspainthatispresentinasurgicalpatientafteraprocedure.Suchpainmaybetheresultoftraumafromtheprocedureorprocedure-relatedcomplications.Painmanagementintheperioperativesettingreferstoactionsbefore,during,andafteraprocedureUpdatedbytheAmericanSocietyofAnesthesiologists(ASA)Com-mitteeonStandardsandPracticeParameters,JeffreyL.Apfelbaum,M.D.(CommitteeChair),Chicago,Illinois;MichaelA.Ashburn,M.D.,M.P.H.(TaskForceChair),Philadelphia,Pennsylvania;RichardT.Con-nis,Ph.D.,Woodinville,Washington;TongJ.Gan,M.D.,Durham,NorthCarolina;andDavidG.Nickinovich,Ph.D.,Bellevue,Washing-ton.ThepreviousupdatewasdevelopedbytheASATaskForceonAcutePainManagement:MichaelA.Ashburn,M.D.,M.P.H.(Chair),SaltLakeCity,Utah;RobertA.Caplan,M.D.,Seattle,Washington;DanielB.Carr,M.D.,Boston,Massachusetts;RichardT.Connis,Ph.D.,Woodinville,Washington;BrianGinsberg,M.D.,Durham,NorthCar-olina;CarmenR.Green,M.D.,AnnArbor,Michigan;MarkJ.Lema,M.D.,Ph.D.,Buffalo,NewYork;DavidG.Nickinovich,Ph.D.,Belle-vue,Washington;andLindaJoRice,M.D.,St.Petersburg,Florida.ReceivedfromtheAmericanSocietyofAnesthesiologists,ParkRidge,Illinois.SubmittedforpublicationOctober20,2011.AcceptedforpublicationOctober20,2011.SupportedbytheAmericanSocietyofAnesthesiologistsanddevelopedunderthedirectionoftheCommitteeonStandardsandPracticeParameters,JeffreyL.Apfelbaum,M.D.(Chair).ApprovedbytheASAHouseofDelegatesonOctober19,2011.AcompletelistofreferencesusedtodeveloptheseupdatedGuidelines,arrangedalphabeti-callybyauthor,isavailableasSupplementalDigitalContent1,:520NorthNorthwestHighway,ParkRidge,Illinois60068-2573.ThesePracticeGuidelines,aswellasallpublishedASAPrac-ticeParameters,maybeobtainedatnocostthroughtheJournalWebsite,*AmericanSocietyofAnesthesiologistsTaskForceonAcutePainManagement:Practiceguidelinesforacutepainmanagementintheperioperativesetting:AnupdatedreportbytheAmericanSocietyofAnesthesiologistsTaskForceonAcutePainManagement.ANESTHESIOLOGY2004;100:1573–81.Copyright©2012,theAmericanSocietyofAnesthesiologists,Inc.LippincottWilliams&Wilkins.Anesthesiology2012;116:248–73•Whatotherguidelinestatementsareavailableonthistopic?XThesePracticeGuidelinesupdatethe“PracticeGuidelinesforAcutePainManagementinthePerioperativeSetting,”adoptedbytheASAin2003andpublishedin2004.*•Whywasthisguidelinedeveloped?XInOctober2010,theCommitteeonStandardsandPracticeParameterselectedtocollectnewevidencetodeterminewhetherrecommendationsintheexistingPracticeGuide-lineweresupportedbycurrentevidence.•Howdoesthisstatementdifferfromexistingguidelines?XNewevidencepresentedincludesanupdatedevaluationofscientificliteratureandfindingsfromsurveysofexpertsandrandomlyselectedASAmembers.Thenewfindingsdidnotnecessitateachangeinrecommendations.•Whydoesthisstatementdifferfromexistingguidelines?XTheASAguidelinesdifferfromtheexistingguidelinesbe-causetheyprovidenewevidenceobtainedfromrecentsci-entificliteratureaswellasfindingsfromnewsurveysofexpertconsultantsandrandomlyselectedASAmembers.Supplementaldigitalcontentisavailableforthisarticle.DirectURLcitationsappearintheprintedtextandareavailableinboththeHTMLandPDFversionsofthisarticle.LinkstothedigitalfilesareprovidedintheHTMLtextofthisarticleontheJournal’sWebsite().Anesthesiology,V116No2February2012248thatareintendedtoreduceoreliminatepostoperativepainbeforedischarge.B.PurposeoftheGuidelinesThepurposeoftheseGuidelinesisto(1)facilitatethesafetyandeffectivenessofacutepainmanagementintheperioperativeset-ting;(2)reducetheriskofadverseoutcomes;(3)maintainthepatient’sfunctionalabilities,aswellasphysicalandpsychologicwell-being;and(4)enhancethequalityoflifeforpatientswithacutepainduringtheperioperativeperiod.Adverseoutcomesthatmayresultfromtheundertreatmentofperi