POST-OPERATIVE PAIN MANAGEMENT IN JORDAN: A DECADE OF PROGRESS AND FUTURE DIRECTIONS (2010–2025)

M. Abu-Jeyyab¹, A. Hamdan², B. Elqadah², M. Alaqrabawi², A.I. Daseh³, A. Alsalahat⁴, M. Abughosh⁵, T. Abdelqader⁶, M.A.R.A. Frietekh⁷ | ¹Istishari Hospital, Amman, Jordan; ²Department of Anesthesia and Resuscitation, Faculty of Allied Medical Sciences, Isra University; Department of Anesthesia and Intensive Care, Istishari Hospital, Amman, Jordan; ³School of Medicine, The Hashemite University, Zarqa, Jordan; ⁴General surgery department, Istishari Hospital, Amman, Jordan; ⁵5th year medical student, Arab American University, Jenin, Palestine; ⁶6th year medical student, Mutah University, Amman, Jordan; ⁷Department of Anesthesia and Intensive Care, Istishari Hospital, Amman, Jordan

Abstract

Background and Aims. Despite global advancements in analgesic techniques, postoperative pain remains a significant clinical challenge in Jordan, impacting recovery and patient satisfaction. Historical audits have consistently highlighted high rates of undertreatment. This review synthesizes evidence from the last 15 years to evaluate the shift in Jordanian perioperative practices and identify remaining barriers to optimal care.
Methods. A narrative review was conducted across PubMed, Scopus, and the Eastern Mediterranean Health Journal for the period 2010–2025. Search terms included "postoperative pain," "analgesia," and "perioperative care" specifically within the Jordanian healthcare context. Twelve landmark studies were selected, covering pain prevalence, nursing knowledge, and pharmacological strategies across various surgical specialties.
Results. The analysis reveals that moderate-to-severe postoperative pain—particularly during mobilization—remains highly prevalent.
- Early Period (2010–2017): Characterized by a heavy reliance on opioid monotherapy (predominantly pethidine), limited integration of multimodal analgesia, and significant deficits in nursing knowledge regarding pain assessment.
- Recent Trends (2018–2025): Data from orthopedic and obstetric departments show a gradual transition toward patient-controlled analgesia (PCA), non-pharmacological interventions, and shared decision-making.
- Persistent Gaps: Despite these improvements, inconsistent protocol adherence and organizational barriers continue to result in suboptimal pain control and frequent drug-related adverse effects.
Conclusions. While Jordan has made strides in adopting modern analgesic technologies, the "knowledge-to-action" gap remains a primary hurdle. To align with international standards, there is an urgent need for:
1. Standardized Multimodal Protocols: Moving beyond opioid-centric models.
2. ERAS Implementation: Integrating Enhanced Recovery After Surgery (ERAS) pathways across all surgical disciplines.
3. Continuous Education: Strengthening nursing and resident training in risk-based pain assessment. Addressing these systemic and educational barriers is essential to reducing the burden of postoperative pain and improving surgical outcomes in the Jordanian healthcare system.