Preoperative morphine pre‐empts postoperative pain

Richmond, Catherine; Bromley, Lesley; Woolf, C. J.

doi:10.1016/0020-7292(94)90799-4

Cited by 27 publications

(45 citation statements)

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“…Richmond et al [46] provided only postoperative relative sensation and pain detection thresholds close to the incision for abdominal hysterectomy, calculated relative to the forearm. At 24 and 48 hours postoperatively, these values were negative in patients receiving nonanalgesic general anesthesia and positive in those with analgesic supplementation (morphine), suggesting the presence of central sensitization inhibited by analgesic supplementation of anesthesia.…”

Section: Mechanical Thresholdsmentioning

confidence: 99%

Changes in sensory processing after surgical nociception

Wilder‐Smith

2000

Current Review of Pain

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Nociception results in peripheral and central changes in sensory processing. These changes are considered to significantly contribute to postoperative pain and its outcome. Objective measures of changes in sensory processing are now being studied in humans after surgery. Surgical nociception leads to both central excitation (eg, spinal sensitization) and central inhibition (eg, descending inhibition), with inhibition being the dominant response during the first day or so after surgery. Analgesia commenced before surgery (preemptive analgesia) depresses central sensitization and enhances central inhibition. Patients operated on under nonanalgesic anesthesia may exhibit rebound central sensitization for up to 5 days postoperatively after the cessation of postoperative opioid analgesia. There is only a weak relationship between the described objective changes in sensory processing after surgical nociception and subjective clinical pain measures such as pain intensity scales or postoperative analgesic consumption.

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Section: Mechanical Thresholdsmentioning

confidence: 99%

Changes in sensory processing after surgical nociception

Wilder‐Smith

2000

Current Review of Pain

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“…Eine sekundäre Hyperalgesie nach punktförmigen mechanischen Reizen um einen Operationsschnitt herum wurde bei postoperativen Patienten nachgewiesen [25,32,36]. Dieser hyperalgetische Bereich in der Nachbarschaft des Operationsschnitts bei postoperativen Patienten konnte durch eine parenterale Ketamininfusion reduziert werden [8,32].…”

Section: Sekundäre Hyperalgesie Bei Postoperativen Schmerzenunclassified

“…Bei postoperativen Patienten konnte durch verschiedene Untersucher eine sekundäre Hyperalgesie nachgewiesen werden; dies zeigt, dass nach einer Operation eine zentrale Sensibilisierung eintritt [25,32]. Welche Rollen sekundäre Hyperalgesie und zentrale Sensibilisierung für postoperative Schmerzen spielen und welche Mechanismen ihnen zugrunde liegen, ist jedoch nicht bekannt [6,7].…”

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Spinale Glutamatrezeptorantagonisten: Differenzierung von primärer und sekundärer mechanischer Hyperalgesie nach operativer Schnittinzision im Tierexperiment

Pogatzki-Zahn

Niemeier

Sorkin

et al. 2006

Schmerz

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Secondary mechanical hyperalgesia has been demonstrated in postoperative patients indicating that central sensitization occurs after surgery. However, the underlying mechanisms are unknown. Here, we studied the role of spinal AMPA/kainate receptors for pain behaviors indicating secondary hyperalgesia caused by gastrocnemius incision in the rat. These were reduced by NBQX, a selective antagonist of AMPA/kainate receptors. However, administration of NMDA receptor antagonists caused no or only a modest decrease in behaviors for secondary hyperalgesia but produced associated motor deficits and supraspinal side effects. We further determined that only secondary mechanical hyperalgesia was reversed by JSTX, a selective antagonist of calcium-permeable AMPA receptor; primary mechanical hyperalgesia and guarding behavior were unchanged. These findings indicate that JSTX influenced a spinal amplification process that leads to secondary hyperalgesia but does not contribute to primary hyperalgesia and guarding after incision. This amplification process likely requires Ca(2) influx through spinal AMPA/KA (but not NMDA) receptors. Behaviors for secondary mechanical hyperalgesia after incision can be inhibited without affecting primary mechanical hyperalgesia and guarding. Mechanisms for central sensitization causing secondary hyperalgesia in postoperative patients may therefore be separated from spontaneous pain and hyperalgesia that arises adjacent to the area of the incision.

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“…Premedication with opioids reduces postoperative pain and increases the interval before the first dose of postoperative analgesic is needed [12][13][14][15][16][17]. When the effect of the local anesthetic wears off, an effective pain-relieving medication is indicated.…”

Section: Introductionmentioning

confidence: 98%

Safety of adjunct pre-emptive intravenous tramadol with midazolam sedation for third molar surgery

Eriksson¹,

Tegelberg

2015

Oral Maxillofac Surg

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The results confirm that pre-emptive intravenous tramadol, administered at 1 mg/kg body weight as an adjunct to midazolam sedation for third molar surgery, offers a safe method. But, it should be noted that our previous study shows that it is not a particularly effective analgesic. Further testing is therefore warranted, using other doses or other drugs, to find a better intravenous protocol for postoperative analgesia, with maximum effect and minimal risk, in outpatient oral and maxillofacial surgery procedures.

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Preoperative morphine pre‐empts postoperative pain

Cited by 27 publications

References 0 publications

Changes in sensory processing after surgical nociception

Changes in sensory processing after surgical nociception

Spinale Glutamatrezeptorantagonisten: Differenzierung von primärer und sekundärer mechanischer Hyperalgesie nach operativer Schnittinzision im Tierexperiment

Safety of adjunct pre-emptive intravenous tramadol with midazolam sedation for third molar surgery

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