Pharmacological and Non-Pharmacological Preoperative Pain Management: A Narrative Review

Abstract

Background:  Effective postoperative pain management improves recovery, maintains haemodynamic stability, and reduces opioid-related risks. While pharmacological interventions such as pregabalin and dexmedetomidine remain widely used, non-pharmacological strategies including music therapy, relaxation techniques, and patient education are increasingly valued for their safety and holistic benefits. However, comparative evaluations of these approaches remain limited.  

Methods: A narrative review was conducted using literature published between 2008 and 2024. Relevant studies were retrieved from PubMed, ScienceDirect, Google Scholar, and Consensus. Inclusion criteria were studies examining preoperative pharmacological and non-pharmacological pain management strategies and their effects on postoperative haemodynamics, recovery, and analgesic use.

 Results: Thirty-four studies met the eligibility criteria. Pharmacological interventions provided rapid analgesia and supported haemodynamic stability, though concerns regarding drug tolerance and opioid dependence were noted. Non-pharmacological approaches reduced anxiety, improved patient satisfaction, and lowered opioid requirements without notable side effects. Combined multimodal strategies yielded the most consistent improvements in pain control, haemodynamic outcomes, and recovery trajectories.

 Conclusion: Both pharmacological and non-pharmacological strategies enhance postoperative outcomes, though their mechanisms and benefits differ. Multimodal integration of these interventions appears most effective in reducing opioid reliance and promoting recovery. Standardized protocols and long-term trials are required to establish optimal combinations tailored to patient and surgical contexts.  

Keywords: Pain management, haemodynamics, pharmacological, non-pharmacological, preoperative, and postoperative.