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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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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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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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Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

348
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...
348
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

919
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
919
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

489
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...
489
Pain01:20

Pain

608
Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
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Updated: Aug 30, 2025

Multi-Modal Signals for Analyzing Pain Responses to Thermal and Electrical Stimuli
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Multimodal Analgesia.

Archana O'Neill1, Philipp Lirk1

  • 1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.

Anesthesiology Clinics
|September 1, 2022
PubMed
Summary
This summary is machine-generated.

Multimodal analgesia optimizes pain control and reduces chronic pain risks by combining various medications and techniques. This approach aims to improve outcomes and avoid opioid-related complications in surgical patients.

Keywords:
Central sensitizationLocal infiltration analgesiaMultimodal analgesiaNerve blockOpioid-induced hyperalgesiaPeripheral sensitizationPersistent postsurgical painPreventive analgesia

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Area of Science:

  • Anesthesiology and Pain Management
  • Surgical Recovery
  • Pharmacology

Background:

  • Effective perioperative pain management is crucial for preventing acute and chronic complications.
  • Over-reliance on opioids can lead to dependence and hyperalgesia.
  • Preventive analgesia strategies aim to mitigate central sensitization, a key factor in chronic pain development.

Purpose of the Study:

  • To review systemic analgesic medications used in multimodal analgesia.
  • To discuss the mechanisms of action and evidence for these medications.
  • To explore regional anesthesia and local infiltration analgesia (LIA) as components of multimodal strategies.

Main Methods:

  • Review of systemic analgesic medications and their evidence.
  • Discussion of regional anesthesia techniques.
  • Examination of local infiltration analgesia (LIA) in orthopedic surgery, specifically total knee arthroplasty.

Main Results:

  • Multimodal analgesia offers a strategy to optimize pain control while minimizing opioid-related adverse effects.
  • Various systemic analgesics play distinct roles in achieving comprehensive pain management.
  • Local infiltration analgesia (LIA) is emerging as a significant alternative in specific surgical contexts like total knee arthroplasty.

Conclusions:

  • Multimodal analgesia is essential for effective perioperative pain management, reducing central sensitization and opioid risks.
  • Systemic medications, regional anesthesia, and LIA are key components of modern pain control strategies.
  • The article provides an overview of evidence-based options for anesthesiologists to enhance postoperative pain relief.