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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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Skeletal Muscle Relaxants: Therapeutic Uses01:31

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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Nociception01:44

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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.
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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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Local Anesthetics: Common Agents and Their Applications01:23

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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
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Centrally Acting Muscle Relaxants: Therapeutic Uses01:24

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Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
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Analgesic Use in Sports.

Dieter Leyk1, Thomas Rüther, Nadine Hartmann

  • 1German Sport University Cologne, Research Group Epidemiology of Performance, Cologne; University of Koblenz; Bundeswehr Institute for Preventive Medicine, Division A Applied Health Promotion, Andernach; Bundeswehrzentralkrankenhaus Koblenz, Department of Anesthesiology and Intensive Care, Koblenz; University Medical Center of the Johannes Gutenberg University Mainz.

Deutsches Arzteblatt International
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Summary

Painkiller use is common in elite sports, with prevalence varying by sport. While prevalent in professional athletes, analgesic use is rare in amateur sports, highlighting a need for education and advertising restrictions.

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Area of Science:

  • Sports Medicine
  • Pharmacology
  • Public Health

Background:

  • Painkiller consumption is widespread in Germany, with millions using analgesics daily and a significant number addicted.
  • Analgesic use is suspected in sports, even without pain, necessitating an investigation into athlete practices.

Approach:

  • A systematic literature review was conducted following PRISMA and PICO(S) criteria.
  • Databases searched included PubMed and SURF, with identified publications evaluated using NOS and AMSTAR tools.

Key Points:

  • Analgesic use is prevalent in elite sports, with prevalence ranging from 2.8% in professional tennis to 54.2% in professional soccer.
  • Prophylactic pain medication use occurs in some non-elite competitive sports.
  • Data on amateur athletes are limited, but monthly analgesic use in connection with sports was reported by 2.1% of endurance athletes.

Conclusions:

  • Analgesic use is a significant issue in professional and competitive sports.
  • Pain medication consumption appears infrequent in amateur sports.
  • Increased education and advertising restrictions are recommended due to rising harmful analgesic use and addiction in the general population.