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Related Concept Videos

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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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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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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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.
158
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

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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...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

458
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...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

684
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Can gabapentinoids decrease perioperative opioid requirements in orthopaedic trauma patients? A single-centre

Pragadeeshwaran Jaisankar1, Bhaskar Sarkar1, Nirvin Paul1

  • 1Department of Trauma Surgery, AIIMS Rishikesh, Uttarakhand, 249203, India.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|July 17, 2023
PubMed
Summary
This summary is machine-generated.

Gabapentin use in extremity fracture surgery significantly reduced the need for opioid analgesics compared to paracetamol alone. This study highlights gabapentin as a valuable non-opioid option for perioperative pain management in orthopaedic trauma.

Keywords:
GabapentinOpioidParacetamolTraumaVAS

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Area of Science:

  • Orthopaedic Surgery
  • Pain Management
  • Pharmacology

Background:

  • Perioperative pain control for orthopaedic trauma/extremity fractures is a significant clinical challenge.
  • Gabapentinoids are increasingly explored as non-opioid adjuncts in various orthopaedic subspecialties.
  • Investigating gabapentin's efficacy in perioperative pain management for extremity fractures is warranted.

Purpose of the Study:

  • To evaluate the effectiveness of gabapentin in conjunction with paracetamol for perioperative pain control in patients with extremity fractures undergoing surgical fixation.
  • To compare opioid analgesic requirements and pain scores between patients receiving gabapentin and paracetamol versus paracetamol alone.

Main Methods:

  • Retrospective comparative study of 119 patients with isolated long bone extremity fractures.
  • Patients were divided into two groups: Gabapentin + Paracetamol (GP) and Non-Gabapentin + Paracetamol (NGP).
  • Gabapentin administered preoperatively and postoperatively; pain assessed via VAS scores and additional opioid use.

Main Results:

  • Significantly lower opioid analgesic requirement in the GP group (41%) compared to the NGP group (74%) (p < 0.01).
  • No significant difference in VAS scores between the groups at all measured time points.
  • Intraarticular fractures in the NGP group showed a significantly higher opioid requirement.

Conclusions:

  • Gabapentin supplementation with paracetamol effectively reduces perioperative opioid consumption in extremity fracture patients.
  • Gabapentinoids offer a viable strategy to mitigate opioid-related complications in trauma surgery pain management.
  • Further research into standardized pain management guidelines for limb trauma is recommended.