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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For drug therapy a differentiation of acute and chronic pain is essential. In emergency situations of acute abdominal pain a fast diagnosis is mandatory. Analgesia should be provided as soon as possible. The different groups of analgesics should be used according to their known effects, side effects and contraindications. Postoperative pain after abdominal surgery has to be considered as a special condition of acute abdominal pain. Main treatment options are non opioid analgesics and opioids. Opioids can be administered intravenously via patient controlled analgesia (PCA) devices. In major abdominal surgery neuroaxial analgesia, preferentially administered via an epidural catheter provides excellent pain relief with positive impact on gastrointestinal motility and patients' recovery. Because of difficulties to allocate chronic abdominal pain to a specific organ, causal treatment often turns out to be difficult. Peripheral and central sensitization, as well as an alteration of the endogenous pain modulation comes to the fore in these chronic pain conditions. Co-analgesics like anticonvulsants and antidepressants are utilized to reduce sensitization and improve the endogenous pain modulating system. Non drug approaches and alternative treatment options might be useful. In contrast, orally or transcutaneously administered opioids are the principal corner stone for the treatment of cancer pain.
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PMID:[Drug therapy of acute and chronic abdominal pain]. 2179 93

Anaesthesiologists will be asked to provide pain management for cancer patients in the absence of more specialised services, when interventional techniques are indicated and in the postoperative period. In all these settings, the complexity of cancer pain and its psychosocial connotations need to be considered to provide appropriate and holistic care. Principles of systemic pain management, effective in most patients, continue to follow established guidelines; identification of neuropathic pain and its appropriate treatment is important here. Interventional pain relief is required in a minority of cancer patients, but it should be considered when appropriate and then done with best available expertise. Neurolytic procedures have lost importance here over the years. Postoperative pain management should be multimodal with consideration of regional techniques when applicable. In managing postoperative pain in cancer patients, opioid tolerance needs to be addressed to avoid withdrawal and poor analgesia. Preventive techniques aiming to reduce chronic postoperative pain should be considered.
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PMID:Pain management for the cancer patient - current practice and future developments. 2426 57

Postoperative pain is a problem that plagues physicians and has since the dawn of the surgical arts. Many interventions are available and used as the standard such as preoperative local anesthetic blocks, opiates, both oral and intravenous, and nonsteroidal antiinflammatory drugs. Although the temptation often exists to increase the postoperative opiate dose, opiate abuse is an increasing problem. This abuse has fueled the search for nonopiate pain adjuncts. Gabapentinoids have been shown to both decrease postoperative pain and, secondarily, decrease opiate dependence. This is a growing field in medical research, although it is relatively lacking in the specialty of lower extremity orthopedic surgery. A PubMed query was performed for related articles, which found only 8 related to lower extremity orthopedic surgery, and of these, none addressed the foot or ankle. Studies involving chronic pain, nonorthopedic surgery, orthopedic procedures proximal to and including the hip, studies involving only pregabalin, and studies regarding cancer pain were excluded. The results from our literature review are encouraging regarding the addition of gabapentin as a regular, perioperative adjunctive pain medication because all studied reported data evaluating preoperative administration have shown a statistically significant reduction in postoperative pain and opiate consumption.
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PMID:Gabapentin as an Adjunct to Standard Postoperative Pain Management Protocol in Lower Extremity Surgery. 2974 3