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2014, Number 1

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Rev Mex Anest 2014; 37 (1)

Basic aspects of postoperative pain and preventive multimodal analgesia

Rosa-Díaz J, Navarrete-Zuazo V, Díaz-Mendiondo M

Language: Spanish
References: 49
Page: 18-26
PDF size: 306.10 Kb.


ABSTRACT

Postoperative pain does not serve a useful function and the risk of not treating it is an increase in postoperative morbidity and mortality. Its successful treatment is one of the most important challenges remaining in the surgical field. Postoperative pain is associated with a noxious stimulus that triggers the pain mechanism by the nociceptive receptors activation. In its production concur all those neurotransmitters and neuromodulators of the conduction pathways and integrators of pain centers and, if pain persists, may evolve to become chronic. In order to solve this complex problem, numerous techniques and various drugs have been investigated. The primary goal of sound management of drugs, is to optimize the efficacy and minimize toxicity. The unimodal analgesia is insufficient, so multimodal therapies are currently recommended, in which different routes of administration and different analgesic or anesthetic drugs are combined, resulting in a synergistic effect which increases the analgesic potency, decreases doses and reduces the possibility of occurrence of side effects. The aim of this review is to present the main mechanisms of development of postoperative pain and relate its control to the mechanism of action of the major groups of analgesic drugs used and to address the preventive use of multimodal analgesia.


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