Related Experiment Video
Updated: Jan 25, 2026
10:29
Principles of Rodent Surgery for the New Surgeon
Published on: January 6, 2011
117.1K
Opioid-Sparing Pain Management in Upper Extremity Surgery: Part 2: Surgeon as Prescriber
Matthew R Bowers1, Nicholas Pulos2, Bridget P Pulos3
1University of Florida College of Medicine, Gainesville, FL.
The Journal of Hand Surgery
|May 16, 2019
Summary
This review explores multimodal pain management for upper extremity surgery, focusing on nonopioid options to reduce opioid use. Part 2 details postoperative nonopioid strategies and future research directions.
Area of Science:
- Pain Management
- Anesthesiology
- Orthopedic Surgery
Background:
- Multimodal pain management combines therapies for enhanced analgesia.
- Reducing opioid requirements is a key goal in surgical pain control.
- Upper extremity surgery presents unique pain management challenges.
Purpose of the Study:
- To review nonopioid analgesic modalities for postoperative pain in upper extremity surgery.
- To identify opioid-sparing anesthetic techniques relevant to upper extremity procedures.
- To explore future research avenues in nonopioid pain management for this patient population.
Main Methods:
- Literature review of nonopioid analgesic modalities.
- Examination of anesthetic techniques for opioid-sparing effects.
- Focus on evidence relevant to upper extremity surgical practice.
Main Results:
- Part 1 reviewed operative anesthesia and analgesia strategies.
- Part 2 discusses available nonopioid options for postoperative pain.
- Identified various nonopioid targets within the pain pathway.
Conclusions:
- Nonopioid strategies are crucial for multimodal pain management post-surgery.
- Optimizing nonopioid analgesia can significantly reduce opioid dependence.
- Further investigation is needed for tailored nonopioid approaches in upper extremity surgery.
Related Concept Videos
01:25Analgesia and Pain Management
1.5K
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...
1.5K
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
967
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...
967
01:30Spare Receptors
4.5K
Some receptors remain unoccupied even when an agonist produces a maximal response. Such empty ones are called spare receptors. In presence of spare receptors the maximum effect of an agonist drug is achieved with fewer than 100% of the receptors being occupied. To determine the presence of spare receptors, scientists often compare the concentration of the drug needed to produce 50% of the maximum effect (EC50) with the concentration of the drug needed to occupy 50% of the receptors (Kd). If the...
4.5K
01:22Opioid Receptors: Overview
4.2K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
4.2K
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
900
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...
900
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
644
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
644