Pre-emptive analgesia: Recent trends and evidences
Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period has the potential to be more effective than a similar analgesic treatment initiated after surgery. This article aims to review all the recent published evidences that assess the efficacy o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Indian Journal of Pain |
| Subjects: | |
| Online Access: | http://www.indianjpain.org/article.asp?issn=0970-5333;year=2013;volume=27;issue=3;spage=114;epage=120;aulast=Mishra |
| _version_ | 1828224179467452416 |
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| author | Amiya K Mishra Mumtaz Afzal Siddhartha S Mookerjee Kasturi H Bandyopadhyay Abhijit Paul |
| author_facet | Amiya K Mishra Mumtaz Afzal Siddhartha S Mookerjee Kasturi H Bandyopadhyay Abhijit Paul |
| author_sort | Amiya K Mishra |
| collection | DOAJ |
| description | Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period has the potential to be more effective than a similar analgesic treatment initiated after surgery. This article aims to review all the recent published evidences that assess the efficacy of this enigmatic concept. Materials and Methods: We reviewed original research articles, case-reports, meta-analyses, randomized control trials (RCTs), and reviews based on pain physiology for preemptive analgesia from Medline, Medscape, and PubMed from 1993 to 2013. A broad free-text search in English was undertaken with major keywords "Preemptive analgesia," "postoperative pain," "preoperative," and "preincisional". Results: Review of publications showed that intravenous (IV) nonsteroidal anti-inflammatory drugs (NSAIDs) are quite effective when used alone, as well as with low dose iv ketamine, preemptively to provide adequate postoperative analgesia. However, ketamine has a doubtful role as a standalone agent. Preemptive administration of LA at the incision site reduces postoperative pain, but achieves an analgesic effect similar to that of postincisional anesthetic infiltration as does intraperitoneal administration. Preemptive epidural analgesia has proved its efficacy in controlling perioperative immune function and pain in comparison to parenteral opioids. Gamma-amino butyric acid (GABA) analogues like gabapentin and pregabalin have great potential as preemptive analgesic with the added advantage of its anxiolytic effect. Conclusion: Multimodal approaches that address multiple sites along the pain pathway is necessary to treat pain adequately. However, we need to find an answer to the question of how to obtain the maximal clinical benefits with the use of preemptive analgesia. |
| first_indexed | 2024-04-12T17:16:41Z |
| format | Article |
| id | doaj.art-41ff85cd98874a798683539c9f754c00 |
| institution | Directory Open Access Journal |
| issn | 0970-5333 |
| language | English |
| last_indexed | 2024-04-12T17:16:41Z |
| publishDate | 2013-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Pain |
| spelling | doaj.art-41ff85cd98874a798683539c9f754c002022-12-22T03:23:37ZengWolters Kluwer Medknow PublicationsIndian Journal of Pain0970-53332013-01-0127311412010.4103/0970-5333.124582Pre-emptive analgesia: Recent trends and evidencesAmiya K MishraMumtaz AfzalSiddhartha S MookerjeeKasturi H BandyopadhyayAbhijit PaulPreemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period has the potential to be more effective than a similar analgesic treatment initiated after surgery. This article aims to review all the recent published evidences that assess the efficacy of this enigmatic concept. Materials and Methods: We reviewed original research articles, case-reports, meta-analyses, randomized control trials (RCTs), and reviews based on pain physiology for preemptive analgesia from Medline, Medscape, and PubMed from 1993 to 2013. A broad free-text search in English was undertaken with major keywords "Preemptive analgesia," "postoperative pain," "preoperative," and "preincisional". Results: Review of publications showed that intravenous (IV) nonsteroidal anti-inflammatory drugs (NSAIDs) are quite effective when used alone, as well as with low dose iv ketamine, preemptively to provide adequate postoperative analgesia. However, ketamine has a doubtful role as a standalone agent. Preemptive administration of LA at the incision site reduces postoperative pain, but achieves an analgesic effect similar to that of postincisional anesthetic infiltration as does intraperitoneal administration. Preemptive epidural analgesia has proved its efficacy in controlling perioperative immune function and pain in comparison to parenteral opioids. Gamma-amino butyric acid (GABA) analogues like gabapentin and pregabalin have great potential as preemptive analgesic with the added advantage of its anxiolytic effect. Conclusion: Multimodal approaches that address multiple sites along the pain pathway is necessary to treat pain adequately. However, we need to find an answer to the question of how to obtain the maximal clinical benefits with the use of preemptive analgesia.http://www.indianjpain.org/article.asp?issn=0970-5333;year=2013;volume=27;issue=3;spage=114;epage=120;aulast=MishraCentral sensitizationpreemptive analgesiapostoperative painsurgery |
| spellingShingle | Amiya K Mishra Mumtaz Afzal Siddhartha S Mookerjee Kasturi H Bandyopadhyay Abhijit Paul Pre-emptive analgesia: Recent trends and evidences Indian Journal of Pain Central sensitization preemptive analgesia postoperative pain surgery |
| title | Pre-emptive analgesia: Recent trends and evidences |
| title_full | Pre-emptive analgesia: Recent trends and evidences |
| title_fullStr | Pre-emptive analgesia: Recent trends and evidences |
| title_full_unstemmed | Pre-emptive analgesia: Recent trends and evidences |
| title_short | Pre-emptive analgesia: Recent trends and evidences |
| title_sort | pre emptive analgesia recent trends and evidences |
| topic | Central sensitization preemptive analgesia postoperative pain surgery |
| url | http://www.indianjpain.org/article.asp?issn=0970-5333;year=2013;volume=27;issue=3;spage=114;epage=120;aulast=Mishra |
| work_keys_str_mv | AT amiyakmishra preemptiveanalgesiarecenttrendsandevidences AT mumtazafzal preemptiveanalgesiarecenttrendsandevidences AT siddharthasmookerjee preemptiveanalgesiarecenttrendsandevidences AT kasturihbandyopadhyay preemptiveanalgesiarecenttrendsandevidences AT abhijitpaul preemptiveanalgesiarecenttrendsandevidences |