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There are a number of pharmacologic strategies for the management of postoperative pain, and all involve the administration of one or more of the most common types of analgesics used in the postoperative period:

• Nonopioids, including oral, rectal, or IV acetaminophen and the NSAIDs (e.g., IV ketorolac or ibuprofen, oral or rectal celecoxib, ibuprofen, or naproxen)
• Opioids, including the first-line options, fentanyl, hydromorphone, morphine, and oxycodone
• Local anesthetics, most often bupivacaine and ropivacaine, used alone for peripheral nerve blocks or in combination with opioids for epidural analgesia
• Anticonvulsants, including gabapentin and pregabalin

Table 5-2 First-line IV Opioids Administered for Postoperative Pain Management: Pharmacokinetic Information

A variety of routes of administration are used to deliver analgesics in the perioperative setting as well. Many of the methods used to manage postoperative pain are accomplished via catheter techniques such as epidural analgesia and continuous peripheral nerve block infusions. Nurses play a key and extensive role in the successful management of these therapies, and the American Society for Pain Management Nursing (ASPMN) provides guidelines for care (Pasero, Eksterowicz, Primeau, & Cowley, 2007; Pasero, Quinn, Portenoy, McCaffery, & Rizos, 2011).