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Perioperative pain control: a strategy for management
Mitchell Jay Cohen1, William P Schecter
1University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
The Surgical Clinics of North America
|December 6, 2005
Summary
Effective perioperative pain management requires understanding pain mechanisms, including inflammation. This review covers nonopioid and opioid analgesics, local anesthesia pharmacology, and pain measurement methods.
Area of Science:
- Pain management
- Neuroscience
- Pharmacology
Background:
- Effective perioperative pain management hinges on understanding pain anatomy and neurophysiology.
- Pain mechanisms, including inflammatory processes, are complex and require detailed study.
Purpose of the Study:
- To provide a comprehensive overview of perioperative pain mechanisms.
- To discuss the pharmacology of various analgesics, including nonopioids and opioids.
- To review local anesthesia, its adverse reactions, and pain measurement techniques.
Main Methods:
- Literature review of pain mechanisms, inflammation, and analgesics.
- Discussion of nonopioid (NSAIDs, acetaminophen) and opioid (morphine, fentanyl, meperidine) pharmacology.
- Examination of local anesthetic pharmacology and adverse reactions.
Main Results:
- Nonopioid analgesics include NSAIDs and acetaminophen.
- Opioid analgesics encompass morphine, fentanyl, and meperidine.
- Local anesthetics have six major adverse reactions: cardiac arrhythmias, hypertension, tissue toxicity, CNS toxicity, methemoglobinemia, and allergic reactions.
Conclusions:
- A thorough grasp of pain neurophysiology is crucial for treating perioperative pain.
- Understanding analgesic pharmacology and local anesthetic risks informs clinical practice.
- Methods for pain assessment are essential components of pain management strategies.