Pain management in cardiothoracic practice.

All analgesia regimens have benefits and side effects, and personal expertise can greatly influence the efficacy of regional techniques. A multimodal approach to analgesic management allows physicians to achieve maximum analgesic efficacy while limiting side effects. An appropriate analgesic plan takes into account the extent of pain associated with the type of incision and adjusts this according to each patient's individual needs. As we enter the new millennium, thoracic and cardiac surgery is becoming more innovative, and the life expectancy of people in the first world is constantly increasing. Older people with less physiologic reserve and more multisystem dysfunction are undergoing more major surgical procedures, and adequate pain control in the postoperative period is becoming increasingly important.