CNS Drugs

, Volume 31, Issue 7, pp 605–615 | Cite as

A Review of Adjunctive CNS Medications Used for the Treatment of Post-Surgical Pain

  • Ajit Rai
  • Howard Meng
  • Aliza Weinrib
  • Marina Englesakis
  • Dinesh Kumbhare
  • Liza Grosman-Rimon
  • Joel Katz
  • Hance ClarkeEmail author
Review Article


Inadequate post-operative pain management can have significant impacts on patients’ quality of life. Effective management of acute pain after surgery is important for early mobilization and discharge from hospital, patient satisfaction, and overall well-being. Utilizing multimodal analgesic strategies has become the mainstay of acute post-operative pain management. A comprehensive search was performed, assessing the published or otherwise publically available literature on different central nervous system (CNS) drugs [excluding opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and acetaminophen] and their uses to treat acute post-surgical pain. Included among the drugs evaluated in this review are anticonvulsants, N-methyl-d-aspartic acid (NMDA) agonists, local anesthetics, α2-agonists, cannabinoids, serotonin–noradrenaline reuptake inhibitors (SNRIs), and serotonin–noradrenaline–dopamine reuptake inhibitors (SNDRIs). Timing, dosing, routes of administration, as well as mechanisms of action are discussed for these CNS drugs.


Compliance with Ethical Standards

Conflict of interest

Ajit Rai, Howard Meng, Aliza Weinrib, Marina Englesakis, Dinesh Kumbhare, Liza Grosman-Rimon, Joel Katz, and Hance Clarke have no financial interests or conflicts of interest to declare.


No funding was received for conducting this review.

Supplementary material

40263_2017_440_MOESM1_ESM.docx (24 kb)
Supplementary material 1 (DOCX 24 kb)


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Pain Research Unit, Department of Anesthesia and Pain Management, Toronto General HospitalUniversity Health NetworkTorontoCanada
  2. 2.Department of AnesthesiaUniversity of TorontoTorontoCanada
  3. 3.Transitional Pain Service, Department of Anesthesia and Pain Management, Toronto General HospitalUniversity Health NetworkTorontoCanada
  4. 4.Library and Information ServicesToronto General HospitalUniversity Health NetworkTorontoCanada
  5. 5.Division of Physical Medicine and Rehabilitation, Department of Medicine, Toronto Rehabilitation InstituteUniversity Health NetworkTorontoCanada
  6. 6.Department of PsychologyYork UniversityTorontoCanada

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