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Nonopioid Analgesic and Adjunct Drugs

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Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care

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Abstract

Nonopioid analgesics play an integral role in multimodal perioperative management of acute surgical pain. Multimodal analgesia involves the use of several different classes of drugs, each in smaller doses, to achieve better pain control than that achieved with the use of any one agent alone. This approach to perioperative pain control aims to reduce narcotic requirements, optimize early return to function, and improve the quality of patients’ perioperative experience by maximizing analgesia while minimizing side effects. Some of the more commonly studied nonopioid analgesics include nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, magnesium, alpha-2 agonists, dexmedetomidine, acetaminophen (IV and PO), and NMDA receptor antagonists. The following sections further elaborate some of the clinical literature supporting the benefit these agents offer as adjuncts to narcotics within a multimodal approach to perioperative pain control.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA

    Mary Bekhit MD

  2. Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Kaveh Navab MD, Andrew Ghobrial MD & Tod Aust MD

Authors
  1. Mary Bekhit MD
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  2. Kaveh Navab MD
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  3. Andrew Ghobrial MD
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  4. Tod Aust MD
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Corresponding author

Correspondence to Mary Bekhit MD .

Editor information

Editors and Affiliations

  1. Departments of Anesthesiology and Pharmacology, LSU Health Sciences Center, New Orleans, Louisiana, USA

    Alan David Kaye

  2. Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California, USA

    Adam M. Kaye

  3. Center for Perioperative Management and Medical Informatics, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Richard D. Urman

Chemical Structures

Chemical Structures

Chemical Structure 9.1
figure 1

Dexamethasone

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Chemical Structure 9.2
figure 2

Dexmedetomidine

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Chemical Structure 9.3
figure 3

Acetaminophen/paracetamol

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Chemical Structure 9.4
figure 4

Ketamine

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Chemical Structure 9.5
figure 5

Ketorolac

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Chemical Structure 9.6
figure 6

Celecoxib

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Bekhit, M., Navab, K., Ghobrial, A., Aust, T. (2015). Nonopioid Analgesic and Adjunct Drugs. In: Kaye, A., Kaye, A., Urman, R. (eds) Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8948-1_9

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  • DOI: https://doi.org/10.1007/978-1-4614-8948-1_9

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