Perioperative pain management has undergone a quiet revolution over the past decade. What once defaulted almost entirely to opioid-based protocols has evolved into something considerably more sophisticated. Dr. Andrew Hummel, MD, a board-certified anesthesiologist and Diplomate of the American Board of Anesthesiology (ABA), has been practicing at the leading edge of that evolution throughout his clinical career.
According to Dr. Hummel, this shift comes from a fundamental rethinking of the anesthesiologist’s role. Historically, anesthesiologists were seen simply as the doctors responsible for keeping patients unconscious and stable during surgery. That understanding was always incomplete. Today, it is increasingly recognized as such.
From Single-Agent to Multimodal
The clearest expression of how perioperative pain management has changed is the move from single-agent opioid-dependent protocols toward multimodal analgesia — combining multiple medications and interventional techniques to address pain through different mechanisms simultaneously.
Dr. Hummel describes the practical effect of this shift clearly. “The goal is to reduce the total opioid burden without sacrificing pain control,” he explained. “That means layering approaches like regional anesthesia, anti-inflammatory agents, and nerve-specific intervention — so that no single element has to carry the entire weight of managing postoperative pain.”
In his own practice, this philosophy is applied through:
- Ultrasound-guided regional anesthesia targeting specific nerve pathways with precision, which is something not achievable through older landmark-based techniques.
- Neuraxial techniques calibrated to individual patient anatomy and surgical requirements.
- Iovera° cryoneurolysis applied pre-surgically for Total Knee Arthroplasty (TKA) patients to temporarily block pain transmission before the first incision.
- Sub-anesthetic ketamine used intraoperatively for opioid-sparing effect.
- Proactive PONV prophylaxis to support earlier mobilization and recovery.
The Perioperative Continuum
What makes Dr. Hummel’s approach distinct is the insistence that pain management is not a post-surgical problem. It is a perioperative one. This means that it requires planning, intervention, and monitoring across the entire arc of the surgical experience, and not just the hours immediately following a procedure.
“The entire surgical day is my domain,” he has stated. “Pre-operative optimization, intraoperative management, and post-operative recovery — these aren’t separate departments. They’re a single continuous responsibility.”
This continuity-of-care philosophy also extends to pre-operative medication reconciliation — including specific protocols for patients on GLP-1 receptor agonists, anticoagulants, and cardiovascular medications that require careful management in the surgical setting.
A Standard Worth Holding
The evolution of perioperative pain management is not finished. New techniques, new pharmacological tools, and new evidence continue to reshape the field. Dr. Andrew Hummel, MD, remains committed to incorporating advances that genuinely serve patients rather than simply following trends — he applies the same rigorous, individualized thinking to pain management that has defined his clinical practice across more than twelve years of active anesthesiology.
About Dr. Andrew Hummel, MD
Andrew Hummel, MD, is a board-certified anesthesiologist and ABA Diplomate based in Missouri. He is a six-time 417 Top Doctor Award recipient and the founder of the Dr. Andrew Hummel Scholarship for Medical Students. To learn more, visit his professional website, andrewhummelmd.com.
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