The American College of Surgeons (ACS) just wrapped up its Clinical Congress 2025 annual meeting. From October 4 to October 7, the ACS Clinical Congress was packed with educational opportunities, presentations featuring groundbreaking research, and networking opportunities for attendees at every stage of their careers.

Today, we’re featuring some of the insightful abstracts that were discussed at the conference. While hundreds of abstracts were presented at the ACS 2025 annual conference, today we're featuring a selection that focuses on intraoperative and postoperative pain management. The following abstracts are published as a supplement to the November issue of the Journal of the American College of Surgeons. 

Intraoperative and Postoperative Pain Management Abstracts Presented at the ACS Clinical Congress 2025

Spinal Vs. General Anesthesia for High-Risk Patients Undergoing Open Inguinal Hernia Repair: A Propensity-Matched Analysis of 30-Day Outcomes

  • Description: General anesthesia is the predominant choice for initial open inguinal hernia repair (OIHR) but is associated with an increased risk of postoperative complication, particularly in patients with multiple comorbidities.
  • Conclusion: In high-risk patients undergoing initial OIHR, spinal anesthesia does not confer a significant 30-day advantage over general anesthesia. Therefore, general anesthesia may be safely used in high-risk patients, while considering patient-specific factors, surgical complexity, and surgeon expertise. Further prospective studies are needed to validate these findings.

Spinal Vs. General Anesthesia in Hip Fracture Surgery: A Large-Scale Analysis of Perioperative Outcomes

  • Description: Despite the prevalence of hip fractures, no standardized anesthesia protocol exists, with both general anesthesia and spinal anesthesia widely used. This study examines a large, contemporary cohort to compare perioperative outcomes between general anesthesia and spinal anesthesia, aiming to guide anesthesia selection in hip fracture operation.
  • Conclusion: Spinal anesthesia was associated with lower rates of major complications, particularly thromboembolic and cardiovascular events.

Efficacy and Safety of Erector Spinae Plane Block in Pain Management for Inguinal Hernia Repair: A Systematic Review and Meta Analysis of Randomized Controlled Trials

  • Description: The study aimed to assess the efficacy and safety of erector spinae plane block (ESPB) in reducing postoperative pain in inguinal hernia repair in adults. ESPB is a new anesthetic technique, but its effective use in hernia repair remains in question. 
  • Conclusion: Researchers found that ESPB is safe for postoperative pain management, noting good effectiveness in laparoscopic inguinal hernia repair, but the efficacy in open hernia repair is uncertain.

Abdominal Binders After Abdominal Surgery: A Systematic Review and Meta-Analysis

  • Description: Abdominal binders are used to manage postoperative pain and improve mobility, but clinical efficacy is unclear. The objective of the study was to evaluate the efficacy and safety of abdominal binder after abdominal surgery.
  • Conclusion: Findings support that abdominal binders improved postoperative pain, physical activity, and SSI rates compared to non-abdominal binders.

A Meta-Analysis of Randomized Control Trials of Single-Port Vs Conventional Laparoscopic Cholecystectomy Comparing Surgical Site Infection, Postoperative Pain and Cosmetic Outcome

  • Description: The goal of the study was to compare the SSI, postoperative pain, and cosmetic result outcomes of SILC and conventional laparoscopic cholecystectomy (CLC), focusing on transumbilical incision (TUI) and periumbilical incision (PUI) types.
  • Conclusion: Findings suggest that SILC may offer better cosmetic outcomes and reduced postoperative pain compared with CLC. No significant difference was found in SSI rates. Subgroup analysis indicates that TUI with a single port may slightly outperform TUI with multiple ports in SSI, pain, and cosmetic outcomes. Researchers indicated that larger sample sizes are needed for confirmation.

Non-Opioid Postoperative Pain Management in Bariatric Surgery

  • Description: The project’s goal was to implement a non-opioid pain regimen after bariatric procedures and evaluate its effectiveness.
  • Conclusion: The results of this project indicate that a non-opioid pain regimen can be effective in managing postoperative pain after bariatric surgery.

Early Opioid Prescribing After Distal Radius Fracture is Associated with New Persistent Opioid Use: A Retrospective Cohort Study

  • Description: Distal radius fractures (DRFs) often require surgical intervention. The frequent use of opioids for postoperative pain have led to concerns regarding new persistent opioid use (NPOU). The goal of this study was to examine whether early postoperative opioid prescribing increased the risk of NPOU after DRF surgery.
  • Conclusion: Researchers noted that early opioid prescription was associated with a higher risk of NPOU, highlighting the need for judicious opioid use and alternative pain management strategies. 

Outcomes After Implementation of a Standardized Opioid-Free Anesthesia Protocol for Laparoscopic Appendectomy in Children

  • Description: Opioid-free anesthesia (OFA) can provide adequate analgesia while avoiding the negative side effects of opioids. The goal of this study was to evaluate the implementation of a standardized OFA protocol during pediatric laparoscopic appendectomy.
  • Conclusion: An OFA protocol achieved adequate perioperative analgesia without compromising the patient’s overall postoperative care.

Impact of 0° vs 30° Endoscope on Postoperative Pain and Opioid Use after Robotic Anatomic Pulmonary Resection: A Retrospective Single Institutional Propensity-Matched Analysis

  • Description: Robotic thoracic surgeons endorse either 0° or 30° endoscope, largely based on personal preference. However, the 30° endoscope is thought to be associated with more postoperative discomfort. Researchers conducted a retrospective single institution analysis to evaluate the impact of 0° or 30° endoscope on postoperative outcomes of robotic anatomic lung resection.
  • Conclusion: The use of 30° endoscope is associated with less pain and opioid use after robotic pulmonary anatomic resection.

Sign up for alerts and stay informed on the latest clinical guidelines and guideline updates.

Copyright © 2025 Guideline Central, all rights reserved.