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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

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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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General Anesthesia: Overview01:24

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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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.
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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 Analgesics: Synthetic and Semisynthetic Opioids01:15

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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...
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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Intracranial Pharmacotherapy and Pain Assays in Rodents
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Anesthesia and Chronic Pain Management.

Anuj Malhotra1, Mourad Shehebar1, Yury Khelemsky2

  • 1Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, KCC 8th Floor, Box 1010, New York, NY 10029, USA.

Otolaryngologic Clinics of North America
|September 30, 2019
PubMed
Summary

Chronic pain development is unclear, but severe acute pain may lead to it. Early, multidisciplinary pain management in head and neck surgery patients can potentially reduce chronic pain.

Keywords:
AnesthesiaChronic painPostoperative pain

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Area of Science:

  • Pain Medicine
  • Otolaryngology
  • Anesthesiology

Background:

  • The etiology of chronic pain remains largely unknown.
  • Chronic postoperative pain is frequently associated with severe acute postoperative pain.
  • Head and neck pain presents a complex diagnostic and therapeutic challenge.

Purpose of the Study:

  • To explore the link between acute and chronic pain in head and neck surgery.
  • To investigate the potential of early multimodal analgesia in preventing chronic pain.

Main Methods:

  • Review of existing literature on chronic pain development.
  • Analysis of pain management strategies in otolaryngologic patients.
  • Focus on the role of multidisciplinary teams and multimodal analgesic regimens.

Main Results:

  • A strong correlation exists between severe acute postoperative pain and the development of chronic pain.
  • Early intervention with multimodal analgesia shows promise in mitigating chronic pain.

Conclusions:

  • Multimodal analgesic regimens, when implemented early by multidisciplinary teams, may help prevent and manage chronic pain in otolaryngologic patients.
  • Further research is warranted to fully elucidate the mechanisms of chronic pain and optimize treatment strategies.