Learning Objectives

Upon completion of this module students will:

  • Explore the physiological and pathophysiological mechanisms for how acute postoperative pain can lead to chronic pain and relevance to post-thoracotomy pain
  • Examine the pharmacology of analgesics including the mechanism of action of common classes of pain medications
  • Discuss multimodal therapy as a strategy to improve the control of postoperative pain and reduce adverse events
  • Apply evidence-based practice guidelines to the care of postoperative patients
  • Discuss key considerations in individualizing analgesic therapy, assessing the response to therapy and monitoring practices to deliver safer, more effective care

Applying Evidence-Based Practice Guidelines

This module incorporates current evidence from the following guidelines to support practice:

  • Acute Post-Surgical Pain Management: A Critical Appraisal of Current Practice
    • Rathmell, JP et al. Regional Anesthesia Pain Medicine. 2006;31(4 suppl 1):1–42.
  • PROSPECT: Evidence-based, Procedure-specific Postoperative Pain Management 
    • Kehlet H, et al. Practice & Research Clinical Anesthesiology. 2007;21:149-159.
  • Acute Pain Management: Scientific Evidence, 3rd ed.
  • American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management: American Pain Society Quality of Care Task Force 
    • Gordon D, Dahl J, Carr D, et al. American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management: American Pain Society Quality of Care Task Force. Archives Of Internal Medicine [serial online]. 2005;165(14):1574-1580. 
  • Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration
    • American Society of Anesthesiologists Task Force on Neuraxial Opioids. Anesthesiology 2009;110:1–13.
  • American Society for Pain Management Nursing Guidelines on Monitoring for Opioid-induced Sedation and Respiratory depression
    • Jarzyna D, et al. Pain Management Nursing. 2011;12:118-145.

Target Audience

This module is best suited for the following student/learner populations:

  • Medical students: 3rd-4th year
  • Nursing junior and senior undergraduate students
  • Nursing graduate students
  • Dental Medicine students: 3rd-4th year
  • Pharmacy students: 3rd-5th year 
  • Physician trainees
  • Clinical nurses
  • Advanced practice nurses
  • Clinical pharmacists


This curriculum resource was supported with funding from the NIH Pain Consortium, which approves the educational value of the information provided. The authors listed on this resource are responsible for its content, and questions may be directed to their Center of Excellence in Pain Education (url). The NIH Pain Consortium provides these evidence-based curriculum resources on pain management as a service to academic medical, dental, nursing, pharmacy and other health professional schools.

This resource is for educational purposes and is not intended as medical practice guidelines. Evidence-based practices may have changed since the publication of the resource.


  • Jenny
    • Marie T. Fisher, MSN, RN, ACNS-BC
  • Dr. Kucharczuk
    • John C. Kucharczuk, MD
  • Nurse Practitioner
    • Patricia Abbott, MHS, PA-C
  • Nurse Practitioner Student
    • Jeanne Papa, ACNP-BC
  • Dr. Cooper
    • Joel D. Cooper, MD, FACS, FRCS
  • Surgical Resident
    • Erik Sylvin, MD
  • Respiratory Therapist
    • Huey. Pigford, RRT
  • Nurse
    • Erin McIlvaine, RN
  • Dr. Polomano
    • Rosemary C. Polomano, PhD, RN, FAAN
  • Dr. Ochroch
    • E. Andrew Ochroch, MD, MSCE
  • Videographer for “Team meeting” and “Nurses’ Station Conference”
    • Chris Simonsen
  • Editing for “Team meeting” and “Nurses’ Station Conference”
    • Chris Simonsen
    • Matthew C. MacDonald, MSEd
  • Additional videos and graphics compliments of  p value communications LLC,  Cedar Knolls, NJ


Hospital of the University of Pennsylvania

  • Michael Ashburn, MD, MPH: Professor of Anesthesiology and Critical Care 
  • Marie T. Fisher, MSN, RN, ACNS-BC: Clinical Nurse Specialist
  • E. Andrew Ochroch, MD, MSCE : Associate Professor of Anesthesiology and Critical Care 
  • Tanya Uritsky, PharmD, BCPS: Clinical Pharmacy Specialist in Pain Management and Palliative Care

University of Pennsylvania School of Nursing

  • Rosemary C. Polomano, PhD, RN, FAAN: Professor of Pain Practice

University of Pennsylvania Perelman School of Medicine

  • John T. Farrar, MD, MSCE, PhD: Associate Professor of Epidemiology in Biostatistics and Epidemiology                 
  • Jun J Mao, MD, MSCE: Associate Professor of Family Medicine and Community Health
  • Matthew C. MacDonald, MSEd: Project Administrator, Center of Excellence in Pain Education
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