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[Systemic analgesia: an update].

Esther M Pogatzki-Zahn1, Peter K Zahn

  • 1Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin des Univklinikums Münster, Germany. pogatzki@anit.uni-muenster.de

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|January 27, 2007
PubMed
Summary
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This review explores systemic adjuvants like ketamine and lidocaine for postoperative pain management, aiming to reduce opioid use and side effects. It also introduces a nurse-led oral analgesic approach for enhanced patient recovery.

Area of Science:

  • Anesthesiology and Pain Management
  • Pharmacology
  • Perioperative Care

Context:

  • Postoperative pain significantly impacts patient recovery and is a critical focus in perioperative care.
  • Current analgesic strategies rely on balanced-multimodal analgesia, often involving patient-controlled administration of local anesthetics and opioids.
  • Systemic opioids, while effective, are associated with dose-limiting side effects.

Purpose:

  • To review recent findings on the effectiveness of various systemically administered adjuvants for postoperative pain treatment.
  • To evaluate non-opioid analgesics, including ketamine, lidocaine, gabapentin, pregabalin, and corticosteroids, as adjuncts to reduce pain and opioid requirements.
  • To introduce a nurse-based oral analgesic concept using controlled-release oxycodone for patients not using patient-controlled analgesia devices.

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Summary:

  • The review discusses the efficacy of systemic adjuvants such as ketamine, lidocaine, gabapentin, pregabalin, and corticosteroids in managing postoperative pain.
  • These adjuvants are considered to reduce reliance on systemic opioids and mitigate their associated adverse effects.
  • A novel nurse-led oral analgesic protocol utilizing controlled-release oxycodone is presented as an alternative for postoperative pain management.

Impact:

  • Provides evidence-based insights into optimizing postoperative pain control through multimodal strategies.
  • Highlights the potential of non-opioid adjuvants to improve patient outcomes and reduce opioid-related complications.
  • Introduces an innovative, nurse-driven approach to enhance analgesic delivery and patient satisfaction in the perioperative setting.