Postoperative pain relief

Abstract

Postoperative pain reliefThe past decade has seen major improvements in the provision of postoperative pain relief. This has been the result of a better understanding of the neurophysiological basis of pain relief, improved methods of organization and delivery of analgesic techniques, and changes in surgical practice. Neurophysiological basis of pain reliefSurgical stress response Effective postoperative pain relief benefits the patient by providing comfort in the period after surgery as well as modifying the autonomic and somatic reflexes to pain which delay recovery. This has led to the realization that effective treatment of acute pain has the potential to attenuate the stress response and facilitate early rehabilitation and recovery.

Preemptive analgesia in the laparoscopic patient

“…We now employ several techniques to accomplish this aim. We employ a multidisciplinary approach [8]. Nursing has high expectations of our laparoscopic patients, and rapid discharge is thereby encouraged.…”

The efficacy of intraincisional local anesthesia on postoperative pain in varicocelectomy

“…[13] Günümüzde ameliyat sonrası ağrının kontrol edilmesi, hastanın konforunu sağlamak ve ağ-rının solunum sistemi, kardiyovasküler sistem, gastrointestinal sistem ve iskelet-kas sistemindeki olumsuz etkilerini de önleme gereksiniminden kaynaklanmaktadır. [14] Ameliyat sonrası ağrı tedavisinde amaç hastanın rahatsızlığını en aza indirmek veya ortadan kaldırmak, derlenmeyi kolaylaştırmak, yan etkilerden kaçınmak veya etkili biçimde önlemek ve ağrıyı ekonomik olarak gidermek olmalıdır. Literatürde sistemik analjezik kullanımında olabilecek komplikasyonlar dile getirilirken, tek doz opioid kullanımının dahi bağımlılı-ğa yol açabileceği belirtilmiş, kronik morfin ve benzeri ilaç kullanımıyla ağrı eşiğinin düşürülerek ameliyat sonrası dönemde ağrının daha da şiddetlenebileceği belirtilmiştir.…”

'Shared spinal cord' scenario: paraplegia following abdominal aortic surgery under combined general and epidural anaesthesia

“…Continuous epidural analgesia is generally regarded as a valuable advancement in perioperative management of patients undergoing major surgery [20, 21]. However, specific aspects of aortic surgery such as intra‐operative heparinisation, possible major bleeding and intraoperative hypotension explain a continuing debate on the risk‐benefit ratio of epidural blocks in major vascular surgery [22, 23].…”