European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
The effect of triple vs. double nonopioid therapy on postoperative pain and functional outcome after abdominal hysterectomy: A randomised double-blind control trial.
Movement-evoked pain is more severe than pain at rest and is likely to interfere more with functional recovery after surgery. ⋯ This trial failed to demonstrate substantial benefits with the addition of a third nonopioid analgesic to three different double-drug regimens. Further research is needed that will more definitively support expanding multimodal analgesic practices. Our results demonstrate consistent correlations between evoked pain and functional outcomes further emphasising the need for improved analgesic regimens that will accelerate postsurgical functional recovery.
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The antidepressant amitriptyline, the inhibitor of microglia activation minocycline, and the neurokinin-1 antagonist maropitant have all been used to prevent or treat hyperalgesia and opioid tolerance. ⋯ Amitriptyline, minocycline and maropitant reduced the minimum alveolar concentration and potentiated the remifentanil minimum alveolar concentration reduction but failed to block opioid-induced hyperalgesia and acute opioid tolerance.