Recent Advances and Future Directions in Perioperative and Chronic Pain Management – A Perspective from Bangladesh

Recent advancements in perioperative pain management have been transformative, particularly the application of ultrasound-guided (USG) regional anesthesia techniques and multimodal analgesia. Ultrasound-guided regional anesthesia allows for real-time visualization of nerves, muscles, and vascular structures, enabling precise needle placement and local anesthetic delivery. This precision significantly enhances block success rates and reduces the risk of complications such as inadvertent nerve injury, vascular puncture, and local anesthetic systemic toxicity (LAST). For example, USG-guided nerve blocks like erector spinae plane block, brachial plexus block, IPACK, and genicular nerve blocks have substantially improved perioperative outcomes by providing superior analgesia, reduced opioid requirements, and faster mobilization, thereby shortening hospital stays and accelerating recovery.