Pre-emptive analgesia: evidence, current status and future directions
| dc.contributor.author | Katz, Joel | |
| dc.date.accessioned | 2012-05-11T15:57:27Z | |
| dc.date.available | 2012-05-11T15:57:27Z | |
| dc.date.issued | 1995 | |
| dc.description.abstract | Although some studies of pre-emptive analgesia have reported small reductions in post-operative pain or analgesic consumption in favour of pre-incisional vs. post-incisional or post-operative treatment, most have not demonstrated any benefit at all. This paper reviews recent evidence supporting the effectiveness of pre-emptive analgesia and discusses factors that may be responsible for the lack of consistent results. These factors include problems with the accepted definition of pre-emptive analgesia, the potential pre-emptive analgesic effects of other agents (e.g. opioids, nitrous oxide, pentobarbitone) used routinely as part of the general anaesthetic, the role of post-operative inflammation in initiating and enhancing a state of central sensitization, and the lack of a true placebo control condition. Given the constraints of clinical research and current standards of practice, it is unlikely that studies of pre-emptive analgesia using conventional analgesics or local anaesthetics will yield large reductions in post-operative pain or analgesic consumption. Extending the pre-emptive treatment well into the post-operative period using balanced, multimodal analgesia, may prolong the initial advantage conferred by the pre-operative blockade and possibly interfere with the development of long-lasting pain. | en_US |
| dc.identifier.citation | European journal of anaesthesiology. Supplement. 10, 8-13. (1995) | |
| dc.identifier.uri | http://hdl.handle.net/10315/14334 | |
| dc.language.iso | en | en_US |
| dc.publisher | Greenwich Medical Media | |
| dc.rights.journal | http://journals.cambridge.org/action/displayJournal?jid=EJA | en_US |
| dc.rights.publisher | http://www.cambridge.org/uk/medicine/gmm/ | en_US |
| dc.subject | pre-emptive analgesia | en_US |
| dc.subject | pain | en_US |
| dc.title | Pre-emptive analgesia: evidence, current status and future directions | |
| dc.type | Article | en_US |