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    Preemptive analgesia II: recent advances and current trends.

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    Authors
    Kelly, D J
    Ahmad, M
    Brull, S J
    Affiliation
    Department of Anaesthesia, Cork University Hospital, Wilton, Cork, Ireland.
    Issue Date
    2012-02-03T15:11:04Z
    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
    
    Metadata
    Show full item record
    Citation
    Can J Anaesth. 2001 Dec;48(11):1091-101.
    Journal
    Canadian journal of anaesthesia = Journal canadien d'anesthesie
    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
    ISSN
    0832-610X (Print)
    0832-610X (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1007/BF03020375
    Scopus Count
    Collections
    Cork University Hospital

    entitlement

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