Health

Negative effects of the untreated or undertreated postoperative pain Acute effect: Increased sympathetic tone, increased catecholamine and catabolic hormone secretion, and decreased secretion of anabolic hormones. The effects include sodium and water retention and increased levels of blood glucose, free fatty acids, ketone bodies, and lactate. A hypermetabolic, catabolic state occurs as metabolism and oxygen consumption …

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Role of ketamine in postoperative pain management Ketamine is traditionally recognized as an intraoperatively administered anesthetic; however, small-dose ketamine can facilitate postoperative analgesia because of its N-methyl-D-aspartate receptor (NMDA)-antagonistic properties, which may be important in attenuating central sensitization and opioid tolerance. Pain therapy can be improved using intravenous subanesthetic ketamine (0.05 to 0.2 mg/kg per hour), …

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When should the postoperative pain management treatment start? Preoperative patient evaluation and planning is integral to perioperative pain management. Proactive individualized planning, premedication, and regional techniques are anticipatory strategies for postoperative analgesia that integrate pain management into the perioperative care of patients. Patient factors to consider in formulating a plan include type of surgery, expected …

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What does multimodal analgesia mean? What are its benefits? Multimodal techniques for pain management include the administration of two or more drugs that act by different mechanisms for providing analgesia, and regional analgesia techniques. The drugs may be administered via the same route or by different routes, and the choice of medication, dose, route, and …

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Does regional analgesia influence surgical outcome? Epidural analgesia: Lower pain scores with epidural analgesia than with systemic opioids. It reduces risk of myocardial infarction and dysrhythmias (thoracic epidural analgesia [TEA] in high-risk patients). It facilitates earlier return of bowel function after major abdominal surgical procedures. The beneficial effect of reduced risk of postoperative pulmonary complications in …

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What is the role of local anesthetics in postoperative pain management? When a local-anesthesia-based regimen is used in epidural analgesia, peripheral nerve block catheters, or local infiltration, it allows continuous analgesia, which is superior to systemic opioids. The beneficial effect of the infiltration of the surgical wound may be extended up to 2 days with …

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How do local anesthetics block nerve function? Local anesthetics block voltage-gated sodium channels, thereby interrupting the initiation and propagation of action potential in axons. Based on this mechanism of action, local anesthetics provide a wide variety of biologic actions, both desirable and unwanted, and have side effects through other mechanisms. In addition to blockade of …

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