Articles: postoperative-pain.
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Am J Health Syst Pharm · Apr 2004
ReviewEmerging techniques in the treatment of postoperative pain.
Causes of inadequate postoperative pain control, challenges with currently available analgesic therapies, characteristics of optimal postoperative analgesic therapy, a liposome-encapsulated, sustained-release dosage form of morphine, and other investigational analgesic therapies are described. ⋯ Opioid analgesics remain the mainstay of postoperative analgesic therapy, but the development of infusion pumps with improved reliability; needle-free technologies, parenteral dosage forms of acetaminophen, selective cyclooxygenase-2 inhibitors, and other non-opioid therapies; and new opioid analgesic agents that provide analgesia without the adverse effects of currently available opioid analgesics may substantially improve postoperative analgesia and health-related quality of life in the postoperative pain patient in the future.
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The mechanisms of persistent postoperative pain, rationale for multimodal pain therapy, and limitations of currently available analgesic agents and administration routes and techniques are described. ⋯ Research is needed to identify analgesic agents and administration techniques with greater efficacy and safety than those currently available.
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Rev Esp Anestesiol Reanim · Apr 2004
Review[A review of clinical evidence supporting techniques to prevent chronic postoperative pain syndromes].
To conduct a systematic review to evaluate the level of evidence for using acute postoperative pain management techniques with a view to pre-empting the later development of chronic pain syndromes. ⋯ Only chronic pain following thoracotomy has been found to be preempted by acute pain management and only by continuous thoracic epidural analgesia started before surgery. There is no solid evidence demonstrating that other techniques used to relieve acute postoperative pain have a beneficial effect in preempting chronic postoperative pain syndromes.
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Many patients continue to suffer moderate pain following surgery. Much of this may be unnecessary and could be alleviated with careful strategic pain management. It appears that the knowledge and attitudes of both health care professionals and patients are pivotal to patients' pain experiences. ⋯ Improvements in pain management can be made by embracing basic pain management principles.