Cost-effectiveness of different postoperative analgesic treatments.

Pain may produce metabolic changes after surgery, which may contribute to further morbidity. A variety of medicines and techniques can be used to successfully treat pain. It is postulated that improved analgesia leads to improved outcomes, although analgesics may also contribute to morbidity. This article reviews the literature evaluating the cost-effectiveness of providing different types of postoperative analgesics and finds that most studies are so poorly conducted that they prevent definitive conclusions being made. The author suggests that further studies be done using analgesics as just one part of a multimodal rehabilitation approach with careful attention to defining outcome, costs and achieving sufficient power to find or exclude meaningful differences.