The effective and safe management of postsurgical pain is an important clinical goal, as an estimated 240 million surgeries are performed each year worldwide.60 Despite increased recognition of acute41 and chronic34 postsurgical pain, and much excellent study of the mechanistic underpinnings of postsurgical pain,7 acute postsurgical pain remains a problem21 for a significant minority of patients. In a recent large study in a variety of surgical types, 28% of patients (of 22,000 patients studied) still experienced moderate-severe acute pain after surgery,24 and a sizable number of patients remain on long-term opioids months after orthopedic surgery.
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