Managing the Operating Room Course for the Complex Pain Patient.

Patients with chronic pain require special attention when formulating the perioperative anesthetic plan. Understanding of the patient's preoperative medication regimen, physical and psychological limitations, type and location of pain, and presence of implanted analgesic devices is necessary to optimize the recovery process and minimize iatrogenic injuries. In general, it is recommended to continue the preoperative analgesic plan if not contraindicated and consider regional anesthetic techniques, multimodal analgesic adjuncts, and protocolized postoperative care plans (such as Enhanced Recovery After Surgery protocols) to expedite a safe and comfortable discharge.