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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Opioid less perioperative care.

Juan P Cata1, Dario Bugada, Jose De Andrés

  • 1Department of Anesthesiology and Perioperative Medicine- MD Anderson Cancer Center, Houston, Texas.

Minerva Anestesiologica
|November 9, 2016
PubMed
Summary

Opioid analgesics are common in surgery but pose risks like adverse events and diversion. Multimodal analgesia strategies are crucial for safer pain management, though opioid-cancer links need more research.

Area of Science:

  • Anesthesiology
  • Pain Management
  • Surgical Care

Background:

  • Opioids are widely used for perioperative pain management due to their effectiveness.
  • However, indiscriminate opioid use leads to significant healthcare problems, including adverse events, opioid-induced hyperalgesia, and drug diversion.
  • The concept of opioid-free or opioid-sparing perioperative care is not yet standard practice in many developed countries.

Purpose of the Study:

  • To highlight the necessity of implementing multimodal analgesia strategies in perioperative care.
  • To underscore the adverse events and risks associated with routine opioid administration.
  • To address the suggested, yet unconfirmed, association between opioid use and cancer progression.

Main Methods:

  • This study is a review and discussion of current practices and literature regarding perioperative pain management.

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  • It synthesizes information on the benefits and drawbacks of opioid analgesia.
  • It emphasizes the need for evidence-based multimodal approaches and further research.

    • Main Results:

    • Opioids are potent analgesics but their overuse presents substantial risks.
    • Multimodal analgesia is essential to mitigate opioid-related adverse events and diversion.
    • Further well-designed studies are required to validate the potential link between opioid use and cancer progression.

    Conclusions:

    • Implementing multimodal analgesia is critical for improving patient safety and reducing opioid-related harms in the perioperative period.
    • Addressing the challenges of opioid dependence and diversion requires a shift towards comprehensive pain management strategies.
    • Investigating the potential impact of opioids on cancer progression warrants rigorous scientific inquiry.