AffiliationDepartment of Anaesthesia, Cork University Hospital, Wilton, Cork, Ireland.
MeSHAnalgesics, Opioid/therapeutic use
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Excitatory Amino Acid Antagonists/therapeutic use
Pain, Postoperative/*prevention & control
MetadataShow full item record
CitationCan J Anaesth. 2001 Dec;48(11):1091-101.
JournalCanadian journal of anaesthesia = Journal canadien d'anesthesie
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.
- Preemptive analgesia I: physiological pathways and pharmacological modalities.
- Authors: Kelly DJ, Ahmad M, Brull SJ
- Issue date: 2001 Nov
- [Preemptive analgesia in postoperative pain for children in otolaryngological department].
- Authors: Przeklasa-Muszyńska A, Nosek-Kozdra K, Muszyński T, Kocot-Kepska M, Podziorny H, Oleś K, Dobrogowski J, Wordliczek Ja, Dardziński W
- Issue date: 2006
- [Preemptive analgesia in cholecystectomy using pethidine].
- Authors: Pjević M, Komarcević M, Kovacević S, Jovanović L, Gajić S
- Issue date: 1999 Nov-Dec
- Preemptive ketamine during general anesthesia for postoperative analgesia in patients undergoing laparoscopic cholecystectomy.
- Authors: Launo C, Bassi C, Spagnolo L, Badano S, Ricci C, Lizzi A, Molinino M
- Issue date: 2004 Oct
- Preemptive analgesia in foot and ankle surgery.
- Authors: Frerichs JA, Janis LR
- Issue date: 2003 Apr