Pain pathways and pre-emptive and protective analgesia for oral surgery.

Aim To describe the scientific basis of the contemporary management of pain after oral surgery. Materials and methods A review of the literature describing the concepts of pre-emptive and protective analgesia and evidence-based practice in the context of managing pain after oral surgery. Results Pain is the consequence of the interplay of numerous chemical mediators and a dynamic and plastic neuronal system, and so pain prevention and management requires the use of different classes of analgesic that act by different mechanisms and at different sites of action, ideally resulting in synergistic analgesia with few side effects. Conclusions Management can be challenging, particularly as much oral surgery is undertaken on an outpatient and day-case basis, but significant improvement can be made to the patient's experience by considering the underlying mechanisms. [ABSTRACT FROM AUTHOR]