Articles: analgesics.
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Minerva anestesiologica · Nov 2024
ReviewMultimodal analgesic strategies in polytraumatized patients.
In recent years, the resuscitation of trauma patients has improved; however, pain related to trauma remains associated with systemic complications. In trauma patients, pain should be considered a vital sign, and its control is crucial for reducing complications, improving patient satisfaction, and enhancing the quality of life. ⋯ In this review, we offer the reader an updated general framework of the various approaches available for pain treatment in polytraumatized patients, with a focus on the opportunities presented by regional anesthesia. We will examine different types of locoregional anesthesia blocks and describe ultrasonographic execution techniques.
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Curr Pain Headache Rep · Nov 2024
ReviewMethadone and Buprenorphine in the Perioperative Setting: A Review of the Literature.
The purpose of this review is to highlight the most recent literature and guidelines regarding perioperative methadone and buprenorphine use. ⋯ Surgical patients taking methadone and buprenorphine are being encountered more frequently in the perioperative period, and providers are becoming more familiar with their pharmacologic properties, benefits as well as precautions. Recommendations pertaining to buprenorphine therapy in the perioperative settings have changed in recent years, owing to more clinical and basic science research. In addition to their use in chronic pain and opioid use disorders, they can also be initiated for acute postoperative pain indications, in select patients and situations. Methadone and buprenorphine are being more commonly prescribed for pain management and opioid use disorder, and their continuation during the perioperative period is generally recommended, to reduce the risk of opioid withdrawal, relapse, or inadequately controlled pain. Additionally, both may be initiated safely and effectively for acute pain management during and after the operating room period.
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Gabapentin, a widely prescribed medication for various neuropathic pain conditions, has demonstrated efficacy in managing diverse neurological disorders. While conventional side effects are well-documented, a growing body of evidence suggests the existence of atypical side effects, necessitating comprehensive exploration. This paper aims to systematically review and summarize the literature on the atypical side effects of gabapentin, shedding light on manifestations beyond the conventional spectrum. ⋯ This comprehensive review highlights the diverse range of atypical side effects associated with gabapentin use, expanding beyond conventional knowledge. Healthcare practitioners must be cognizant of these manifestations, recognizing their potential impact on patient well-being. As clinical decision-making relies on a thorough understanding of a medication's side effect profile, this review contributes to enhancing awareness and fostering informed practices in the prescription and management of gabapentin. Further research is warranted to elucidate the mechanisms and risk factors associated with these atypical side effects, refining our understanding of gabapentin's safety profile.
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Anesthesia and analgesia · Nov 2024
Meta AnalysisDoes Nociception Level Index-Guided Opioid Administration Reduce Intraoperative Opioid Consumption? A Systematic Review and Meta-Analysis.
The nociception level (NOL) index is a quantitative parameter derived from physiological signals to measure intraoperative nociception. The aim of this systematic review and meta-analysis was to evaluate if NOL monitoring reduces intraoperative opioid use compared to conventional therapy (opioid administered at clinician discretion). ⋯ This meta-analysis does not provide evidence supporting the role of NOL monitoring in reducing intraoperative opioid consumption.
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Acta Anaesthesiol Scand · Nov 2024
ReviewOpioids and personalized analgesia in the perioperative setting: A protocol for five systematic reviews.
Treatment with opioids is a mainstay in perioperative pain management. While the leading treatment paradigm has been procedure-specific pain management, efforts regarding personalized pain treatment are increasing. The OPI•AID project aims to develop personalized algorithms for perioperative pain management, taking demographic, surgical, and anaesthesiologic factors into account. We will undertake five parallel reviews to illuminate current evidence on different aspects of individual responses to perioperative opioid treatment. ⋯ These reviews will evaluate various aspects of perioperative opioid treatment, including individualized treatment strategies, selection of specific opioids, and individual patient responses. These will guide future development of a personalized perioperative opioid treatment algorithm (OPI•AID) that will be validated and tested clinically against standard of care.