Management of postoperative pain and emesis

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
P F White

Abstract

As more extensive and painful surgical procedures (e.g., laparoscopic cholecystectomy, laminectomy, knee and shoulder reconstruction, hysterectomy) are being performed on an outpatient basis, the availability of sophisticated postoperative analgesic regimens are necessary to optimize the benefits of day-case surgery for both the patient and the health care provider. However, outcome studies are needed to evaluate the effects of these newer therapeutic approaches with respect to postoperative side effects, cost and important recovery variables. Recent studies suggest that factors other than pain per se must be controlled in order to reduce postoperative morbidity and facilitate the recovery process. Not surprisingly, the anaesthetic technique can influence the analgesic requirements and the likelihood of emesis in the early postoperative period. Although opioid analgesics will continue to play an important role, the adjunctive use of both local anaesthetic agents and NSAIDs will probably assume an even greater role in the future. Use of drug combinations (e.g., opioids with local anaesthetics, alpha2 agonists and/or NSAIDs) may provide for improved analgesia with fewer opioid-related side effects than narcotic analgesics alone. ...Continue Reading

References

Jul 1, 1992·Anesthesiology·M F Watcha, P F White
Sep 1, 1991·Anesthesia and Analgesia·P A Kapur
Aug 1, 1989·British Journal of Anaesthesia·E N Armitage
Dec 1, 1994·Anesthesia and Analgesia·A J SouterP F White
Nov 1, 1993·Anesthesia and Analgesia·H Kehlet, J B Dahl

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Citations

Sep 5, 2002·Journal of Clinical Anesthesia·Beverly K PhilipSteven P Burch
Aug 6, 1999·Journal of Clinical Anesthesia·J TangA Sloninsky
Nov 7, 2000·Acta Anaesthesiologica Scandinavica·V Dahl, J C Raeder
May 13, 1999·Journal of Advanced Nursing·H J Thompson
Mar 29, 2000·Journal of Vascular and Interventional Radiology : JVIR·G P SiskinE G Dolen
Mar 20, 2004·Journal of Advanced Nursing·Anne Marie CollLaurence G Moseley
Jan 11, 2013·Journal of Pain & Palliative Care Pharmacotherapy·Gary M OderdaScott B Robinson
Jan 26, 2002·The American Journal of Gastroenterology·Randall R StoltzRichard C Hubbard
Feb 18, 2005·Acta Anaesthesiologica Scandinavica·M G C CruvinelP Kux
Mar 11, 1999·Anesthesia and Analgesia·S I Marshall, F Chung
Feb 9, 2012·American Journal of Physical Medicine & Rehabilitation·Maristella Borges SilvaLuciane Fernanda Rodrigues Martinho Fernandes
Jun 1, 1996·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·R A Marley

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