Preemptive analgesia II: recent advances and current trends.

Hdl Handle:
http://hdl.handle.net/10147/209056
Title:
Preemptive analgesia II: recent advances and current trends.
Authors:
Kelly, D J; Ahmad, M; Brull, S J
Affiliation:
Department of Anaesthesia, Cork University Hospital, Wilton, Cork, Ireland.
Citation:
Can J Anaesth. 2001 Dec;48(11):1091-101.
Journal:
Canadian journal of anaesthesia = Journal canadien d'anesthesie
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209056
DOI:
10.1007/BF03020375
PubMed ID:
11744585
Abstract:
PURPOSE: This two-part review summarizes the current knowledge of physiological mechanisms, pharmacological modalities and controversial issues surrounding preemptive analgesia. SOURCE: Articles from 1966 to present were obtained from the MEDLINE databases. Search terms included analgesia, preemptive; neurotransmitters; pain, postoperative; hyperalgesia; sensitization, central nervous system; pathways, nociception; anesthetic techniques; analgesics, agents. Principal findings: In Part I of this review article, techniques and agents that attenuate or prevent central and peripheral sensitization were reviewed. In Part II, the conditions required for effective preemptive techniques are evaluated. Specifically, preemptive analgesia may be defined as an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The most important conditions for establishment of effective preemptive analgesia are the establishment of an effective level of antinociception before injury, and the continuation of this effective analgesic level well into the post-injury period to prevent central sensitization during the inflammatory phase. Although single-agent therapy may attenuate the central nociceptive processing, multi-modal therapy is more effective, and may be associated with fewer side effects compared with the high-dose, single-agent therapy. CONCLUSION: The variable patient characteristics and timing of preemptive analgesia in relation to surgical noxious input require individualization of the technique(s) chosen. Multi-modal analgesic techniques appear more effective.
Language:
eng
MeSH:
Analgesics, Opioid/therapeutic use; *Anesthesia, Conduction/trends; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use; Excitatory Amino Acid Antagonists/therapeutic use; Humans; Pain, Postoperative/*prevention & control
ISSN:
0832-610X (Print); 0832-610X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKelly, D Jen_GB
dc.contributor.authorAhmad, Men_GB
dc.contributor.authorBrull, S Jen_GB
dc.date.accessioned2012-02-03T15:11:04Z-
dc.date.available2012-02-03T15:11:04Z-
dc.date.issued2012-02-03T15:11:04Z-
dc.identifier.citationCan J Anaesth. 2001 Dec;48(11):1091-101.en_GB
dc.identifier.issn0832-610X (Print)en_GB
dc.identifier.issn0832-610X (Linking)en_GB
dc.identifier.pmid11744585en_GB
dc.identifier.doi10.1007/BF03020375en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209056-
dc.description.abstractPURPOSE: This two-part review summarizes the current knowledge of physiological mechanisms, pharmacological modalities and controversial issues surrounding preemptive analgesia. SOURCE: Articles from 1966 to present were obtained from the MEDLINE databases. Search terms included analgesia, preemptive; neurotransmitters; pain, postoperative; hyperalgesia; sensitization, central nervous system; pathways, nociception; anesthetic techniques; analgesics, agents. Principal findings: In Part I of this review article, techniques and agents that attenuate or prevent central and peripheral sensitization were reviewed. In Part II, the conditions required for effective preemptive techniques are evaluated. Specifically, preemptive analgesia may be defined as an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The most important conditions for establishment of effective preemptive analgesia are the establishment of an effective level of antinociception before injury, and the continuation of this effective analgesic level well into the post-injury period to prevent central sensitization during the inflammatory phase. Although single-agent therapy may attenuate the central nociceptive processing, multi-modal therapy is more effective, and may be associated with fewer side effects compared with the high-dose, single-agent therapy. CONCLUSION: The variable patient characteristics and timing of preemptive analgesia in relation to surgical noxious input require individualization of the technique(s) chosen. Multi-modal analgesic techniques appear more effective.en_GB
dc.language.isoengen_GB
dc.subject.meshAnalgesics, Opioid/therapeutic useen_GB
dc.subject.mesh*Anesthesia, Conduction/trendsen_GB
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal/therapeutic useen_GB
dc.subject.meshExcitatory Amino Acid Antagonists/therapeutic useen_GB
dc.subject.meshHumansen_GB
dc.subject.meshPain, Postoperative/*prevention & controlen_GB
dc.titlePreemptive analgesia II: recent advances and current trends.en_GB
dc.contributor.departmentDepartment of Anaesthesia, Cork University Hospital, Wilton, Cork, Ireland.en_GB
dc.identifier.journalCanadian journal of anaesthesia = Journal canadien d'anesthesieen_GB
dc.description.provinceMunster-

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