Multimodal Analgesia for Acute Postoperative and Trauma-Related Pain

Rosemary C Polomano1, Mechele Fillman, Nicholas A Giordano

  • 1Rosemary C. Polomano is a professor of pain practice at the University of Pennsylvania School of Nursing, Philadelphia. Mechele Fillman is an NP for the acute pain service in the Division of Pain Medicine at Stanford Hospital and Clinics, Stanford, CA. Nicholas A. Giordano is a PhD student and Hillman Scholar in Nursing Innovation at the University of Pennsylvania School of Nursing. April Hazard Vallerand is associate dean for research and director of the PhD program at Wayne State University College of Nursing, Detroit. Kelly L. Wiltse Nicely is an assistant professor of nurse anesthesia in the Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing. Carla R. Jungquist is an assistant professor in the University at Buffalo School of Nursing, Buffalo, NY. Contact author: Rosemary C. Polomano, polomanr@nursing.upenn.edu. Rosemary C. Polomano has served on the advisory boards of Salix Pharmaceuticals, Daiichi Sankyo, and Mallinckrodt Pharmaceuticals; April Hazard Vallerand is on the speaker's bureaus of AstraZeneca and Purdue Pharma and is a consultant for Shionogi, Inc.; and Carla R. Jungquist has served on the advisory board of Mallinckrodt Pharmaceuticals. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

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...
2.5K
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
1.3K
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
488
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
1.3K
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
893
Nociception01:44

Nociception

Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
33.6K