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Postoperative opioid analgesia: time for a reconsideration?
H Kehlet1, G W Rung, T Callesen
1Department of Surgical Gastroenterology, Hvidovre University Hospital, Denmark.
Journal of Clinical Anesthesia
|September 1, 1996
Summary
Postoperative pain management has advanced with new analgesics and administration methods, including intravenous and epidural infusions. This allows for reduced opioid use and fewer side effects, supporting early recovery after surgery.
Area of Science:
- Anesthesiology
- Pharmacology
- Surgical Recovery
Background:
- Postoperative pain relief has seen significant advancements.
- New analgesics and administration routes, like intravenous (IV) and epidural infusions, have emerged.
- The concepts of preemptive and balanced analgesia are increasingly recognized.
Purpose of the Study:
- To review the role of opioid analgesics in postoperative pain management.
- To evaluate opioid-sparing effects of various analgesic techniques.
- To reassess opioid use in the context of ambulatory surgery and accelerated recovery programs.
Main Methods:
- Analysis of controlled clinical studies focusing on opioid-sparing effects.
- Inclusion of studies with multiple dosing regimens and adequate patient sample sizes.
- Review of data concerning different surgical procedures and assessment criteria.
Main Results:
- Newer analgesic techniques and administration routes allow for lower total opioid dosages.
- Improved methods provide more stable opioid concentrations, enhancing analgesic effects.
- Reduced opioid use is associated with fewer unwanted side effects, facilitating functional analgesia.
Conclusions:
- Opioid analgesics, while historically significant, may have limited future use due to side effects and alternatives.
- Ambulatory surgery and early recovery programs necessitate a re-evaluation of opioid utilization.
- Functional analgesia, enabling normal patient function, is a key goal in modern postoperative care.