Pain management in presurgery, discharge and rehabilitation in joint replacement: pre.di.re.

Osteoarthritis is a painful and debilitating disease that affects millions of patients. It is defined by a progressive break- down and loss of cartilage, accompanied by significant pain and functional disability. Joint replacement surgery has proved to be a highly successful method to restore normal function. However, many patients suffer from severe acute postoperative pain, which has immediate implications for early recovery and the possibility of participating in accelerated rehabilitation programs and, although less recognized, many develop chronic pain after surgery, which can be, at least in part, the result of untreated preoperative osteoarthritis pain and/or chronic postoperative pain. currently, precise indica- tions are available in the literature on the appropriate and effective treatment of pain in the immediate postoperative phase (48-72 hours) after hip or knee arthroplasty. The multimodal management of pain in the perioperative phase includes the use of drugs and other tools to reduce the dosage of opioid analgesics, decrease complications, improve results and increase patient satisfaction. The purpose of this work was to review the problems related to pain and related to the pre- operative, the discharge and rehabilitation phase (pre.di.re.) and try to systematise optimal treatment for these patients.