Pregledni rad
https://doi.org/10.20471/acc.2023.62.s4.16
Evidence-Based Strategies for Multimodal Postoperative Pain Management
Višnja Majerić Kogler
; Specialist of Anesthesiology, Reanimatology and Intensive Medicine, Professor of Anesthesiology, Reanimatology and Intensive Medicine, School of Medicine, Zagreb, Croatia, retired
Mirjana Lončarić Katušin
; Specialist of Anesthesiology, Reanimatology and Intensive Medicine, General Hospital Karlovac,Aassistant Professor of Anesthesiology, Reanimatology and Intensive Medicine, School of Medicine Rijeka, Rijeka, Croatia
Jana Kogler
; Specialist of Anesthesiology, Reanimatology and Intensive Medicine, Department of Anesthesiology, Reanimatology and Intensive Medicine, University Hospital Center Zagreb, Senior Assistant of Anesthesiology, Reanimatology and Intensive Medicine, School of Medicine Zagreb, Zagreb, Croatia
Sažetak
Surgery causes postoperative pain that should be immediately and effectively treated.
Postoperative pain management is in central focus when planning postoperative treatment and is becoming
the standard of care after surgical protocols – Enhanced Recovery after Surgery (ERAS). There are various
serious complications associated with poorly controlled postoperative pain in adult surgical patients
– cardiopulmonary complications, unplanned hospital admission, prolonged hospital stays, development
of chronic pain, opioid side effects, opioid hyperalgesia and addiction. Studies have identified activation
and sensitization of peripheral nociceptors and spinal dorsal horn neurons after surgical incision, and their
specific mechanisms have been investigated. Basic scientific data and many clinical investigations suggest
that different pain states result depending on the type and location of the incision, and that additional
surgical procedures cause pain states of various severities in other sites. Supported by basic science, these
observations have led to the development of the concept of procedure-specific postoperative pain management.
The main value and novelty of procedure-specific postoperative pain management guidelines are
that the guidelines are evidence-based, consider relevant patient characteristics, the role of anesthetic and
surgical techniques, the balance between the invasiveness of the analgesic technique and the intensity of
postoperative pain, as well as balance between analgesic efficacy and adverse event profile of the analgesic
medications and procedures. In this review, the authors discuss the preventive and multimodal strategies
of acute pain therapy, the pharmacotherapy of multimodal analgesia and local and regional techniques for
specific surgical procedures.
Ključne riječi
postoperative pain management; procedure-specific analgesia; multimodal and preventive analgesia; evidence-based data
Hrčak ID:
316574
URI
Datum izdavanja:
1.11.2023.
Posjeta: 0 *