Anesthesiologists: The Experts in Pain Management

With September being Pain Awareness month, we thought we would share how anesthesiologists are the medical world’s experts in pain management. Read on to learn how anesthesiologists minimize patients’ experiences with pain and what our organization, Ontario’s Anesthesiologists, is doing to prevent one of pain management’s biggest challenges: The opioid crisis. 

Managing Acute Surgical Pain
While pain can be classified in several ways, the two best known categories are acute or chronic pain. The former—which we’ll discuss in more detail below —is a specific pain lasting for at least three months, while acute pain is experienced over a shorter timeline; it’s what you feel when you stub your toe, break your arm, or following surgery.     

During surgical procedures, anesthesiologists primarily use two kinds of medication to keep a patient comfortable. The first group, the anesthetics, is what renders a patient unconscious. The second group are the analgesics, which are the painkillers. This is the medication that keeps a patient from feeling acute pain during surgery.

Exactly which painkillers will be used, and how they will be administered, depends on the surgery and the patient’s medical history. In some cases, an anesthesiologist will administer a nerve block. This procedure involves injecting local anesthetic near or around the nerves in a  specific part of the body to block pain signals from where the procedure is occurring. One of the best-known examples of a nerve block is an epidural, which is commonly used during labour. Nerve blocks can potentially last for a few hours and can be extended for several days after surgery to provide optimal post-surgical pain management. 

Most surgical patients will receive intravenous (IV) pain medication during their procedure, and this technique may also continue for a short period after surgery until the patient is able to eat and drink. Oral medication (pills) are frequently given once a patient has regained consciousness, and many patients leave the hospital with a prescription for medication that will help them manage their pain over the next few days or weeks, depending on the intensity of the procedure.

What that prescription is for can vary. For more minor procedures, acetaminophen (Tylenol) and/or a nonsteroidal anti-inflammatory (such as ibuprofen) may be enough to control the pain. 

More serious procedures may require more powerful painkillers. The best-known class of these drugs is opioids, a group that includes codeine, morphine, and fentanyl. It’s essential for patients to understand that the opioid drugs used in medical settings are highly regulated, and most have been safely and effectively used for decades. While opioids, and fentanyl in particular, have been receiving bad press over the last few years, these drugs are vital tools in an anesthesiologist’s toolbox of painkillers. Most people can safely take these drugs, and by doing so, can experience a quicker and more comfortable recovery.

If you or a loved one has an upcoming surgery and have questions or concerns about the medications or procedures being used, please speak to your health-care provider.

Since the invention and adoption of anesthesia in the late 18th century, the management of  surgical pain has evolved significantly. One of those evolutions has been emphasizing better pain management in the days following surgery. We now know that effective management of surgical pain speeds up recovery and reduces the risk of chronic pain and other potential complications, allowing patients to resume their regular lives more quickly.

We are also increasingly incorporating non-pharmaceutical interventions that can decrease surgical pain. These techniques can vary from physiotherapy to heat to meditation.

While it’s impossible to eliminate all pain immediately following surgery, the medical community is steadily improving how surgical pain is controlled. We’re proud to share that anesthesiologists are leading the way in this space.


Managing Chronic Pain
Chronic pain is one of Canada’s biggest health-care challenges. Approximately one in five Canadians will find themselves coping with this condition at some point in their lives.

How to best treat chronic pain is the subject of much research and discussion. There is no single treatment protocol, and even powerful prescription painkillers can fail to deliver relief for some (and create serious side effects for others).

What is clear is is that chronic pain is best treated by those who are formally trained in the practice. To access this expertise, many patients turn to chronic pain clinics where they may be treated by an anesthesiologist who specializes in treating chronic pain.

Anesthesiologists who focus on this area have received additional specialized training, and many also conduct research on chronic pain. Their extensive knowledge of anatomy, physiology and pharmaceuticals brings a level of expertise to the table that is highly sought after by pain patients.

The care delivered by these sub-specialists is catered to each individual patient. Treatment can include nerve blocks and/or other injections, oral medications and referrals for physical therapy or possibly even surgery.

Over-the-counter and prescription medications are frequently recommended to patients. However, opioid-based pills are generally not prescribed for the long-term treatment of chronic pain. Non-pharmaceutical techniques, such as physio and massage therapy, are also increasingly being incorporated into patient’s treatment plans. 

How We’re Helping to Fight the Opioid Crisis
Opioids are a class of drugs anesthesiologists are very familiar with; we couldn’t do our job without them! But they also have another side. Since 2016, over 30,000 Canadian lives have been lost due to opioid-related overdoses.

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4. Youth and Prescription Painkillers. CAMH (Internet). (cited 2022 February). Available here.

While most of these deaths are the result of illicit drugs including illegal fentanyl, we believe that better management of prescription opioids and pain management will result in less misuse of forms of opioids.

Unfortunately, prescription drugs are sometimes diverted into the illicit pill market or become a “gateway” product for illegal opioid use. Additionally, as many as 10 per cent of surgical patients may persistently use opioids past the standard treatment course. At the same time, it’s important to remember that opioids can be critical for minimizing acute pain. A reluctance to use them can result in poorer patient experiences, which can negatively impact both individuals’ recovery and the broader health-care system.

 As Ontario’s experts in pain management, we feel our organization has an important role to play in fighting the opioid crisis. In 2021, we launched SolvingPain.ca, our digital harm-prevention tool. It aims to efficiently provide physicians with the information they need to provide their patients with optimal pain control using evidence-based practices that also limit the potential for opioid misuse. Its first initiative, the Perioperative Pain Management Pathway, features recommendations for over 50 common surgeries, including hip replacements and Caesarean sections. It also houses a collection of resources that can be shared with patients.

If you’re a health-care professional involved in pain management, we encourage you to explore SolvingPain.ca and share it with your colleagues.

While anesthesiologists may be best known for “putting people to sleep,” our role as the medical world’s experts in pain management means our presence and skills can be found beyond the operating room. We aim to optimize pain management for both acute and chronic pain patients and we’re conducting crucial research on how to further minimize— and even prevent—pain. We’re also actively contributing our expertise when it comes to the opioid crisis and working to minimize opioid misuse while ensuring that people have access to the pain control they need. To stay on top of how we’re working to solve pain in Canada, please follow us on Instagram, Facebook, LinkedIn or X (formerly known as Twitter).