Multimodal, Good depth preemptive Analgesia (including COUNSELLING) is the key determinant of the intensity of Postoperative pain in any Surgery or Procedure. Pre Emptive Analgesia — Analgesia  / Analgesics administered before the onset of  Painful stimulus/injury to tissues. This includes — 1) Psychological COUNSELLING, Psychological Analysis Of  Patient,  and Mental preparation ( empowerment) of patients  + Building up of Confidence on Doctors. 2)  Anxiolytic drugs  - an hour before, sometimes even 12hrs before may be required in some cases.

Lorazepam, Clonazepam, Zolpidem, Midazolam etc. 3) Analgesics — Opioids, NSAIDs (inhibit prostaglandin synthesizing enzymes  - before the substrate lipid is released from injured tissues). 4) Spinal Anaesthesia — Adequate  Bupivacaine  + long-acting  INTRATHECAL Adjuvants  like long-acting Opioids, Clonidine, Dexmedetomidine etc  5) NSAIDs…