術後痛ガイドライン―既存のガイドラインとの比較，特徴―

The New Postoperative Pain Management Guideline from the Japan Society of Pain Clinicians

1　策定された経緯

　日本ペインクリニック学会は2025年，『術後痛ガイドライン』（以下，本GL）を刊行した^1）。この背景には，わが国において術後痛の管理の不十分さが長年にわたり指摘されてきたという現状がある。手術患者の80％以上は術後痛を有し，そのうち75％以上は中等度以上の痛みを経験する^2）。術後痛は手術侵襲に起因する生理的反応である一方，適切な鎮痛管理が行われなければ，術後回復を阻害し，術後合併症を増加させる。呼吸・循環，認知機能が悪化し，入院期間を延長させ医療経済上の負担も無視できないものとなっている^3）。また，術後急性期の痛みが遷延化し，慢性術後痛（chronic postsurgical pain：CPSP）として長期にわたって痛みに苦しむことにもなりうる。

　In 2025, the Japan Society of Pain Clinicians（JSPC）published a new guideline for the management of patients’ postoperative pain（POP）. Despite some progress that has been made, POP remains insufficiently controlled in many patients, thus contributing to delayed recoveries, prolonged hospitalization, and an increased healthcare burden. The new guideline presents evidence-based recommendations for POP that encompass pharmacologic approaches, nerve blocks, and multimodal strategies. Notably, the JSPC guideline adopts a clinical question format, offering practical guidance with clearly stated recommendations and supporting evidence. Compared to the existing international guidelines, the new JSPC guideline differs by including a detailed discussion on chronic postoperative pain and its prevention. It also emphasizes multidisciplinary collaboration and individualized care. By addressing procedure-specific pain management and fostering standardized clinical decision-making, the new JSPC guideline aims to improve both short- and long-term postoperative patient outcomes. This document serves as a valuable reference for all healthcare professionals involved in perioperative care.