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Warren-Stomberg M. 2, Brattwall M. 1, Jakobsson J. G. 3
1 Department of Anesthesiology and Intensive care, Institution for Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden;
2 University of Gothenburg/the Sahlgrenska Academy, Institute of Health and Care Sciences, Gothenburg, Sweden;
3 Anesthesia and Intensive Care, Institution for Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
Multimodal pain management, combining analgesics with different mode of action in order to minimize occurrence of side-effects still providing safe and efficacious pain management after ambulatory surgery has become standard of care. The combined use of local anaesthesia in order to reduce noxious influx during the procedure and reduce postoperative pain is strongly recommended whenever feasible. Providing oral analgesics paracetamol, and none-steroid anti-inflammatory drugs or selective Cox-II-inhibitors already prior to induction in order to provide effective therapeutic concentrations at end of surgery is a simple and easy way to facilitate the recovery. Single iv. preoperative dose dexamethasone has been shown not only to be effective in reducing postoperative nausea and vomiting but also to improve recovery reduce pain and improve satisfaction. Pregabalin may be used in order to further enhance the recovery and pain management.