Pain Management Strategies in Cancer Surgery: Anaesthetic and Technological Innovations
Abstract
A structured narrative review examining contemporary anaesthetic, pharmacological and technological approaches to perioperative pain management in cancer surgery.
Pain is one of the most common and distressing symptoms experienced by patients following cancer surgery, significantly affecting recovery, functional outcomes and quality of life. Although surgical techniques have advanced, many patients continue to experience moderate to severe postoperative pain. Concerns regarding opioid-related side effects and long-term dependence have driven the development of multimodal and opioid-sparing pain management strategies.
This review summarises the epidemiology, causes and management of pain in cancer surgery patients, with emphasis on anaesthetic and technological advancements, interdisciplinary collaboration and future directions focusing on perioperative pain outcomes.
The study was conducted as a structured narrative review of literature published between 2000 and 2025 focusing on anaesthetic and technological innovations in perioperative pain management for cancer surgery. PubMed, Scopus and Google Scholar were searched. Twenty-seven articles were selected through independent screening and consensus-based inclusion according to predefined eligibility criteria.
Current evidence supports multimodal opioid-sparing strategies for improved recovery; however, no anaesthetic technique has demonstrated a consistent long-term oncological benefit.
Structured synthesis of current literature.
Articles initially identified by the reviewers.
Articles considered after duplicate removal.
Articles selected for final synthesis.
Combining Analgesic Strategies
The review supports multimodal approaches combining different analgesic classes and techniques to improve pain control while reducing reliance on systemic opioids.
Targeted Pain Control
Regional techniques including epidural analgesia, paravertebral blocks and peripheral nerve blocks provide important options for procedure-specific pain management in cancer surgery.
Reducing Opioid Exposure
Opioid-sparing protocols are increasingly incorporated into perioperative cancer care to reduce opioid-related adverse effects while maintaining effective analgesia.
Greater Precision in Regional Blocks
Ultrasound-guided nerve blocks permit real-time visualisation of relevant anatomy and local anaesthetic spread, supporting more precise regional anaesthetic techniques.
Remote & Real-Time Pain Assessment
Wearable devices, mobile applications and telemedicine are emerging as tools for pain assessment, patient-reported outcomes, medication support and remote perioperative follow-up.
Patient-Controlled Analgesia
Patient-controlled analgesia can improve patient autonomy and pain control. Newer systems may incorporate wireless connectivity, integrated monitoring and data analytics.
Enhanced Recovery Pathways
ERAS protocols integrate preoperative optimisation, multimodal opioid-sparing analgesia, minimally invasive care, early mobilisation and early nutrition to support recovery following cancer surgery.
Long-Term Evidence Remains Uncertain
Although modern anaesthetic approaches can improve perioperative pain and recovery, the review concludes that no anaesthetic technique has demonstrated a consistent long-term oncological benefit.
Team-Based Pain Management
Optimal cancer pain management involves collaboration among anaesthesiologists, surgeons, pain specialists, nurses, physiotherapists and psychologists.
AI, Digital Health & Personalisation
Future developments highlighted in the review include artificial intelligence for pain-risk prediction, telemedicine, novel analgesic delivery systems, patient-reported outcomes and increasingly personalised perioperative care.
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Review Article
A structured narrative review examining contemporary pain-management strategies in cancer surgery with particular emphasis on anaesthetic and technological innovations.
2000–2025
The review considered relevant literature published between 2000 and 2025.
PubMed · Scopus · Google Scholar
The literature search used PubMed, Scopus and Google Scholar to identify publications relevant to perioperative pain management in cancer surgery.
27 Articles
The reviewers initially identified 90 articles. Following removal of 25 duplicates, 65 articles proceeded to full-text review and 27 were selected for the final narrative synthesis.
Conceptual Synthesis
The study was designed as a structured narrative review and did not use formal risk-of-bias scoring because its purpose was conceptual synthesis rather than quantitative comparison.
Multimodal Analgesia
The review describes multimodal analgesia as a central component of contemporary cancer surgery pain management, combining different analgesic classes and techniques to maximise pain relief while limiting adverse effects.
Procedure-Specific Analgesia
Regional anaesthetic options discussed include epidural analgesia, paravertebral blocks, peripheral nerve blocks and continuous catheter techniques.
Digital & Anaesthetic Innovation
The review examines ultrasound-guided nerve blocks, neuromonitoring, wearable technologies, mobile applications, telemedicine and innovations in patient-controlled analgesia.
ERAS
Enhanced Recovery After Surgery pathways combine preoperative optimisation, intraoperative multimodal opioid-sparing care and postoperative strategies such as early mobilisation, nutrition and effective pain control.
Long-Term Oncological Outcomes
Although anaesthetic innovations improve perioperative pain control, available evidence does not demonstrate a definitive or consistent long-term oncological benefit from any particular anaesthetic technique.
AI & Digital Health
Future directions identified by the authors include artificial-intelligence-based pain-risk prediction, personalised analgesic planning, expanded telemedicine, novel analgesics and delivery systems, and greater patient engagement.
No Human or Animal Participants
No animal subjects or human participants were involved in the review; therefore, ethical approval or informed consent was not required.
Author Contributions
Shaistha Banu:
Conceptualization, literature search, writing draft,
review and editing.
Jocelin Harriate D. Almeida:
Literature search, critical review, review and editing.
Conflict of Interest & Funding
Conflict of Interest:
No conflict of interest.
Funding:
No funding received by the authors.
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CC BY 4.0
This article is published by The Operating Room Global
Journal under the Creative Commons Attribution 4.0
International licence.
DOI: 10.64573/torgj2602001
Volume 2 · Issue 1 · 2026
The Operating Room Global Journal (TORGJ).
ISSN 3105-3262.
Review Article.
Article ID: TORGJ-MS2602001.
DOI: 10.64573/torgj2602001.
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