Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.

中文翻译：

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非创伤性急诊普外科的术后疼痛管理：WSES-GAIS-SIAARTI-AAST 指南

非创伤性急诊普外科涉及可能患有多种潜在疾病的异质人群。及时的紧急手术治疗应辅之以高质量的围手术期护理，最好由经过培训的多学科团队来识别和处理复杂的术后过程。不受控制或控制不佳的急性术后疼痛可能会导致严重的并发症。虽然择期手术后的疼痛管理已在围手术期路径中标准化，但对接受急诊手术的患者进行的传统围手术期治疗往往是一种随意的做法。目前推荐的疼痛管理指南适用于非创伤性​​紧急手术干预后的疼痛管理。它旨在为临床医生提供一份适应症清单，即使在没有多学科疼痛团队的情况下，也可以开出最佳镇痛药。一个国际专家小组在随后的几轮讨论中讨论了不同的问题。四个国际公认的科学学会：世界急诊外科学会 (WSES)、全球外科感染联盟 (GAIS)、意大利麻醉、镇痛重症监护学会 (SIAARTI) 和美国创伤外科学会 (AAST)，获得认可该项目并批准了最终手稿。在急诊腹部手术环境中处理急性术后疼痛是复杂的，需要特别注意，并且应该是多学科的。有几种工具可用，只要有可能，它们的组合是强制性的。针对不同情况和条件的镇痛方法应以患者为基础，并根据手术、病理、年龄、反应和可用的专业知识进行调整。更好地了解术后疼痛的短期和长期结果的病理机制对于改进预防和治疗策略是必要的。