CNS Drugs

, Volume 21, Issue 3, pp 185–211

Perioperative Pain Management

Review Article

Abstract

The under-treatment of postoperative pain has been recognised to delay patient recovery and discharge from hospital. Despite recognition of the importance of effective pain control, up to 70% of patients still complain of moderate to severe pain postoperatively.

The mechanistic approach to pain management, based on current understanding of the peripheral and central mechanisms involved in nociceptive transmission, provides newer options for clinicians to manage pain effectively. In this article we review the rationale for a multimodal approach with combinations of analgesics from different classes and different sites of analgesic administration. The pharmacological options of commonly used analgesics, such as opioids, NSAIDs, paracetamol, tramadol and other non-opioid analgesics, and their combinations is discussed. These analgesics have been shown to provide effective pain relief and their combinations demonstrate a reduction in opioid consumption.

The basis for using non-opioid analgesic adjuvants is to reduce opioid consumption and consequently alleviate opioid-related adverse effects. We review the evidence on the opioid-sparing effect of ketamine, clonidine, gabapentin and other novel analgesics in perioperative pain management. Most available data support the addition of these adjuvants to routine analgesic techniques to reduce the need for opioids and improve quality of analgesia by their synergistic effect. Local anaesthetic infiltration, epidural and other regional techniques are also used successfully to enhance perioperative analgesia after a variety of surgical procedures. The use of continuous perineural techniques that offer prolonged analgesia with local anaesthetic infusion has been extended to the care of patients beyond hospital discharge.

The use of nonpharmacological options such as acupuncture, relaxation, music therapy, hypnosis and transcutaneous nerve stimulation as adjuvants to conventional analgesia should be considered and incorporated to achieve an effective and successful perioperative pain management regimen.

References

  1. 1.
    Dolin SJ, Cashman JN, Bland JM. Effectiveness of acute postoperative pain management: I. Evidence from published data. Br J Anaesth 2002 Sep; 89(3): 409–23PubMedGoogle Scholar
  2. 2.
    Warfield CAMD, Kahn CHMD. Acute pain management: programs in U.S. hospitals and experiences and attitudes among U.S. adults. Anesthesiology 1995 Nov; 83(5): 1090–4Google Scholar
  3. 3.
    Apfelbaum JL, Chen C, Mehta SS, et al. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003; 97(2): 534–40PubMedCrossRefGoogle Scholar
  4. 4.
    Ferrell B, Virani R, Grant M, et al. Analysis of pain content in nursing textbooks. J Pain Symptom Manage 2000 Mar; 19(3): 216–28PubMedCrossRefGoogle Scholar
  5. 5.
    Salantera S, Lauri S, Salmi TT. Nurses knowledge about pharmacological and non-pharmacological pain management in children. J Pain Symptom Manage 1999 Oct; 18(4): 289–99PubMedCrossRefGoogle Scholar
  6. 6.
    Page GG. The immune-suppressive effects of pain. Adv Exp Med Biol 2003; 521: 117–25PubMedGoogle Scholar
  7. 7.
    Rosenfeld BA, Faraday N, Campbell D, et al. Hemostatic effects of stress hormone infusion. Anesthesiology 1994; 81(5): 1116–26PubMedCrossRefGoogle Scholar
  8. 8.
    Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiol Clin North America 2005; 23(1): 21–36PubMedCrossRefGoogle Scholar
  9. 9.
    Michaloliakou C, Chung F, Sharma S. Preoperative multimodal analgesia facilitates recovery after ambulatory laparoscopic cholecystectomy. Anesth Analg 1996; 82(1): 44–51PubMedGoogle Scholar
  10. 10.
    Wu C, Richman J. Postoperative pain and recovery profile. Curr Opin Anesthesiol 2004; 17: 455–60CrossRefGoogle Scholar
  11. 11.
    Strassels SA, Chen C, Carr DB. Postoperative analgesia: economics, resource use, and patient satisfaction in an urban teaching hospital. Anesth Analg 2002; 94(1): 130–7PubMedGoogle Scholar
  12. 12.
    Kehlet H, Werner M, Perkins F. Balanced analgesia: what is it and what are its advantages in postoperative pain? Drugs 1999; 58(8): 793–7PubMedCrossRefGoogle Scholar
  13. 13.
    Hyllested M, Jones S, Pedersen JL, et al. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth 2002; 88(2): 119–214CrossRefGoogle Scholar
  14. 14.
    Buvanendran A, Kroin JS, Tuman KJ, et al. Effects of perioperative administration of a selective cyclooxygenase 2 inhibitor on pain management and recovery of function after knee replacement: a randomized controlled trial. JAMA 2003; 290(18): 2411–8PubMedCrossRefGoogle Scholar
  15. 15.
    Woolf CJ, Bennett GJ, Doherty M, et al. Towards a mechanism-based classification of pain? Pain 1998; 77(3): 227–9PubMedCrossRefGoogle Scholar
  16. 16.
    Sorkin LS, Wallace MS. Acute pain mechanisms. Surg Clin North Am 1999; 79(2): 213–29PubMedCrossRefGoogle Scholar
  17. 17.
    Brimijoin S, Lundberg JM, Brodin E, et al. Axonal transport of substance P in the vagus and sciatic nerves of the guinea pig. Brain Res 1980; 191(2): 443–57PubMedCrossRefGoogle Scholar
  18. 18.
    DeVane CL. Substance P: a new era, a new role. Pharmacotherapy 2001 Sep; 21(9): 1061–9PubMedCrossRefGoogle Scholar
  19. 19.
    Meller ST, Gebhart GF. Nitric oxide (NO) and nociceptive processing in the spinal cord. Pain 1993; 52(2): 127–36PubMedCrossRefGoogle Scholar
  20. 20.
    Yamamoto T, Sakashita Y. The role of the spinal opioid receptor likel receptor, the NK-1 receptor, and cyclooxygenase-2 in maintaining postoperative pain in the rat. Anesth Analg 1999; 89(5): 1203–8PubMedCrossRefGoogle Scholar
  21. 21.
    Dionne RA, Max MB, Gordan SM, et al. The substance P receptor antagonist CP-99, 994 reduces acute postoperative pain. Clin Pharmacol Ther 1998 Nov; 64(5): 562–8PubMedCrossRefGoogle Scholar
  22. 22.
    Gonzalez MI, Field MJ, Holloman EF. Evaluation of PD 154075, a tachykinin NK1 receptor antagonist, in a rat model of postoperative pain. Eur J Pharmacol 1998 Mar 5; 344(2–3): 115–20PubMedCrossRefGoogle Scholar
  23. 23.
    Goldstein DJ, Wong O, Todd LE, et al. Study of the analgesic effect of lanepitant in patients with osteoarthritis pain. Clin Pharmacol Ther 2000 Apr; 67(4): 419–26PubMedCrossRefGoogle Scholar
  24. 24.
    Hill R. NK1 (substance P) receptor antagonists: why are they not analgesic in humans? Trends Pharmacol Sci 2000 July; 21(7): 244–6PubMedCrossRefGoogle Scholar
  25. 25.
    Dray A. Peripheral mediators of pain: the pharmacology of pain. Handbook Exp Pharmacol. 1997; 130: 21–42CrossRefGoogle Scholar
  26. 26.
    Lang E, Novak P, Reeh P. Chemosensitivity of fine afferents from rat skin in vitro. J Neurophys 1990; 63: 887–901Google Scholar
  27. 27.
    Stanfa LC, Dickenson AH, Xu X-J, et al. Cholecystokinin and morphine analgesia: variations on a theme. Trends Pharmacol Sci 1994; 15: 65–6PubMedCrossRefGoogle Scholar
  28. 28.
    Baber NS, Dourish CT, Hill DR. The role of CCK caerulein, and CCK antagonists in nociception. Pain 1989; 39(3): 307–28PubMedCrossRefGoogle Scholar
  29. 29.
    Headley PM, Grillner S. Excitatory amino acids and synaptic transmission: the evidence for a physiological function. Trends Pharmacol Sci 1990; 11(5): 205–11PubMedCrossRefGoogle Scholar
  30. 30.
    Kangrga I, Randic M. Outflow of endogenous aspartate and glutamate from the rat spinal dorsal horn in vitro by activation of low- and high-threshold primary afferent fibers: modulation by mu-opioids. Brain Res 1991; 553(2): 347–52PubMedCrossRefGoogle Scholar
  31. 31.
    Dickenson AH. Spinal cord pharmacology of pain. Br J Anaesth 1995; 75(2): 193–200PubMedCrossRefGoogle Scholar
  32. 32.
    Rogawski MA. Therapeutic potential of excitatory amino acid antagonists: channel blockers and 2,3-benzodiazepines. Trends Pharmacol Sci 1993; 14(9): 325–31PubMedCrossRefGoogle Scholar
  33. 33.
    De Kock M, Lavand’homme P, Waterloos H. ‘Balanced analgesia’ in the perioperative period: is there a place for ketamine? Pain 2001; 92(3): 373–80PubMedCrossRefGoogle Scholar
  34. 34.
    Monconduit L, Bourgeais L, Bernard JF, et al. Ventromedial thalamic neurons convey nociceptive signals from the whole body surface to the dorsolateral neocortex. J Neurosci 1999; 19(20): 9063–72PubMedGoogle Scholar
  35. 35.
    Yoshimura M, Furue H. Mechanisms for the anti-nociceptive actions of the descending noradrenergic and serotonergic systems in the spinal cord. J Pharmacol Sci 2006; 101(2): 107–17PubMedCrossRefGoogle Scholar
  36. 36.
    Jones SL. Descending noradrenergic influences on pain. Prog Brain Res 1991; 88: 381–94PubMedCrossRefGoogle Scholar
  37. 37.
    Li P, Zhuo M. Cholinergic, noradrenergic, and serotonergic inhibition of fast synaptic transmission in spinal lumbar dorsal horn of rat. Brain Res Bull 2001; 54: 639–47PubMedCrossRefGoogle Scholar
  38. 38.
    Segal IS, Jarvis DJ, Duncan SR, et al. Clinical efficacy of oral-transdermal clonidine combinations during the perioperative period. Anesthesiology 1991; 74(2): 220–5PubMedCrossRefGoogle Scholar
  39. 39.
    Kehlet H, Dahl JB. The value of ‘multimodal’ or ‘balanced analgesia’ in postoperative pain treatment. Anesth Analg 1993; 77: 1048–56PubMedCrossRefGoogle Scholar
  40. 40.
    Kehlet HH, Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth 2001; 87(1): 62–72PubMedCrossRefGoogle Scholar
  41. 41.
    Kehlet H. Effect of postoperative pain treatment on outcome-current status and future strategies. Langenbecks Arch Surg 2004; 389: 244–9PubMedCrossRefGoogle Scholar
  42. 42.
    Werner MU, Soholm L, Rotboll-Nielsen P, et al. Does an acute pain service improve postoperative outcome? Anesth Analg Nov 2002; 95(5): 1361–72CrossRefGoogle Scholar
  43. 43.
    Spaulding TC, Fielding S, Venafro JJ, et al. Antinociceptive activity of clonidine and its potentiation of morphine analgesia. Eur J Pharmacol 1979; 58(1): 19–25PubMedCrossRefGoogle Scholar
  44. 44.
    Altman RD. A rationale for combining acetaminophen and NSAIDs for mild-to-moderate pain. Clin Exper Rheumatol 2004; 22(1): 110–7Google Scholar
  45. 45.
    Ng A, Smith G, Davidson AC. Analgesic effects of parecoxib following total abdominal hysterectomy. Br J Anaesth 2003; 90(6): 746–9PubMedCrossRefGoogle Scholar
  46. 46.
    Manzo S, Takao K, Takehiko K, et al. Determining the plasma concentration of ketamine that enhances epidural bupivacaine and morphine induced analgesia. Anesth Analg 2005; 101(3): 777–84CrossRefGoogle Scholar
  47. 47.
    Chia YY, Liu K, Liu YC, et al. Adding ketamine in a multimodal patient-controlled epidural regimen reduces postoperative pain and analgesic consumption. Anesth Analg 1998; 86(6): 1245–9PubMedGoogle Scholar
  48. 48.
    Lavand’homme P, De Kock M, Waterloos H. Intraoperative epidural analgesia combined with ketamine provides effective preventive analgesia in patients undergoing major digestive surgery. Anesthesiology Oct 2005; 103(4): 813–20CrossRefGoogle Scholar
  49. 49.
    Bjordal JM, Johnson MI, Ljunggreen AE. Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption: a meta-analysis with assessment of optimal treatment parameters for postoperative pain. Eur J Pain 2003; 7(2): 181–8PubMedCrossRefGoogle Scholar
  50. 50.
    Fassoulaki A, Triga A, Melemeni A. Multimodal analgesia with gabapentin and local anesthetics prevents acute and chronic pain after breast surgery for cancer. Anesth Analg 2005; 101(5): 1427–32PubMedCrossRefGoogle Scholar
  51. 51.
    Bisgaaard T, Klarskov B, Kehlet H, et al. Preoperative dexamethasone improves surgical outcome after laparoscopic cholecystectomy: a randomised double-blind placebo-controlled trial. Ann Surg 2003 Nov; 238(5): 651–60CrossRefGoogle Scholar
  52. 52.
    Schumann R, Shikora S, Weiss JM, et al. A comparison of multimodal perioperative analgesia to epidural pain management after gastric bypass surgery. Anesth Analg 2003 Feb; 96(2): 469–74PubMedGoogle Scholar
  53. 53.
    Wu CL, Naqibuddin M, Rowlingson AJ, et al. The effect of pain on health-related quality of life in the immediate postoperative period. Anesth Analg 2003; 97(4): 1078–85PubMedCrossRefGoogle Scholar
  54. 54.
    Fortier J, Chung F, Su J. Unanticipated admission after ambulatory surgery: a prospective study. Can J Anaesth 1998 Jul; 45(7): 612–9PubMedCrossRefGoogle Scholar
  55. 55.
    Block BM, Liu SS, Rowlingson AJ, et al. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA 2003; 290(18): 2455–63PubMedCrossRefGoogle Scholar
  56. 56.
    Kaneko M, Saito Y, Kirihara Y, at al. Synergistic antinociceptive interaction after epidural coadministration of morphine and lidocaine in rats. Anesthesiology 1994; 80: 137–50PubMedCrossRefGoogle Scholar
  57. 57.
    Förster JG, Rosenberg PH. Small dose of clonidine mixed with low-dose ropivacaine and fentanyl for epidural analgesia after total knee arthroplasty. Br J Anaesth 2004; 93: 670–7PubMedCrossRefGoogle Scholar
  58. 58.
    Renghi A, Gramaglia L, Ciarlo M, et al. Fast track in abdominal aortic surgery. Minerva Anestesiol 2001; 67(6): 441–6PubMedGoogle Scholar
  59. 59.
    Peyton PJ, Myles PS, Silbert BS, et al. Perioperative epidural analgesia and outcome after major abdominal surgery in high-risk patients. Anesth Analg 2003; 96(2): 548PubMedGoogle Scholar
  60. 60.
    De Leon-Casasola OA. When it comes to outcome, we need to define what a perioperative epidural technique is. Anesth Analg 2003 Feb; 96(2): 315–18PubMedGoogle Scholar
  61. 61.
    Singelyn F, Gouverneur J. Postoperative analgesia after total hip arthroplasty: a prospective evaluation by our acute pain service in more than 1300 patients. J Clin Anesth 1999; 11: 550–4PubMedCrossRefGoogle Scholar
  62. 62.
    Likar R, Sittl R, Gragger K, et al. Peripheral morphine analgesia in dental surgery. Pain 1998; 76(1–2): 145–50PubMedCrossRefGoogle Scholar
  63. 63.
    Likar R, Koppert W, Blatnig H, et al. Efficacy of peripheral morphine analgesia in inflamed, non-inflamed and perineural tissue of dental surgery patients. J Pain Symptom Manage 2001; 21(4): 330–7PubMedCrossRefGoogle Scholar
  64. 64.
    Eriksson H, Tenhunen A, Korttila K. Balanced analgesia improves recovery and outcome after outpatient tubal ligation. Acta Anaesthes Scand 1996; 40(2): 151–5CrossRefGoogle Scholar
  65. 65.
    Bisgaard T, Klarskov B, Kristiansen VB, et al. Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study. Anesth Analg 1999; 89(4): 1017–24PubMedGoogle Scholar
  66. 66.
    Gwirtz KH, Young JV, Byers RS, et al. The safety and efficacy of intrathecal opioid analgesia for acute postoperative pain: seven years’ experience with 5969 surgical patients at Indiana University Hospital. Anesth Analg 1999; 88(3): 599–604PubMedGoogle Scholar
  67. 67.
    Hartrick CTM, Martin GM, Kantor GM, et al. Evaluation of a single dose extended release epidural morphine formulation for pain relief after knee arthroplasty. J Bone Joint Surg 2006; 88(2): 273–81PubMedCrossRefGoogle Scholar
  68. 68.
    Gambling D, Hughes T, Martin G, et al. A comparison of Depodur, a novel, single dose extended-release epidural morphine, with standard epidural morphine for pain relief after lower abdominal surgery. Anesth Analg 2005; 100: 1065–74PubMedCrossRefGoogle Scholar
  69. 69.
    Carvalho B, Riley E, Cohen SE. Single-dose, sustained-release epidural morphine in the management of postoperative pain after elective cesarean delivery: results of a multicenter randomized controlled study. Anesth Analg 2005; 100: 1150–8PubMedCrossRefGoogle Scholar
  70. 70.
    Kehlet H, Werner MU. Role of paracetamol in acute pain management [in French]. Drugs 2003; 63 Spec No. 2: 15–21CrossRefGoogle Scholar
  71. 71.
    Cobby TF, Crighton IM, Kyriakides K. Rectal paracetamol has a significant morphine-sparing effect after hysterectomy. Br J Anaesth 1999 Aug; 83(2): 253–6PubMedCrossRefGoogle Scholar
  72. 72.
    Sinatra RS, Jahr JS, Reynolds LW, et al. Efficacy and safety of single and repeated administration of 1 gram intravenous acetaminophen injection (paracetamol) for pain management after major orthopedic surgery. Anesthesiology 2005; 102(4): 822–31PubMedCrossRefGoogle Scholar
  73. 73.
    Edwards JE, McQuay HJ, Moore RA. Combination analgesic efficacy: individual patient data meta-analysis of single-dose oral tramadol plus acetaminophen in acute postoperative pain. J Pain Symptom Manage 2002; 23(2): 121–30PubMedCrossRefGoogle Scholar
  74. 74.
    Zhou TJ, Tang J, White PF. Propacetamol versus ketorolac for treatment of acute postoperative pain after total hip or knee replacement. Anesth Analg 2001; 92(6): 1569–75PubMedCrossRefGoogle Scholar
  75. 75.
    Alexander R, El-Moalem HE, Gan TJ. Comparison of the morphine-sparing effects of diclofenac sodium and ketorolac tromethamine after major orthopedic surgery. J Clin Anesth 2002; 14(3): 187–92PubMedCrossRefGoogle Scholar
  76. 76.
    Van Dyke T, Litkowski LJ, Kiersch TA, et al. Combination oxycodone 5 mg/ibuprofen 400mg for the treatment of postoperative pain: a double-blind, placebo- and active-controlled parallel-group study. Clin Therap 2004; 26(12): 2003–14CrossRefGoogle Scholar
  77. 77.
    Pickering AE, Bridge HS, Nolan J, et al. Double-blind, placebo-controlled analgesic study of ibuprofen or rofecoxib in combination with paracetamol for tonsillectomy in children. Br J Anaesth 2002; 88(1): 72–7PubMedCrossRefGoogle Scholar
  78. 78.
    Reinhart D. Minimising the adverse effects of ketorolac. Drug Saf 2000; 22: 487–97PubMedCrossRefGoogle Scholar
  79. 79.
    Gan TJ, Joshi GP, Zhao SZ, et al. Presurgical intravenous parecoxib sodium and follow-up oral valdecoxib for pain management after laparoscopic cholecystectomy surgery reduces opioid requirements and opioid-related adverse effects. Acta Anaesthes Scand 2004; 48(9): 1194–207CrossRefGoogle Scholar
  80. 80.
    Mehlisch DR, Desjardins PJ, Daniels S, et al. The analgesic efficacy of intramuscular parecoxib sodium in postoperative dental pain. J Am Dental Assoc 2004; 135(11): 1578–90Google Scholar
  81. 81.
    Daniels S, Kuss M, Mehlisch D, et al. Pharmacokinetic and efficacy evaluation of intravenous parecoxib in postsurgical dental pain. Clin Pharmacol Ther 2000; 67: 1–8CrossRefGoogle Scholar
  82. 82.
    Tang J, Li S, White PF, et al. Effect of parecoxib, a novel intravenous cyclooxygenase type-2 inhibitor, on the postoperative opioid requirement and quality of pain control. Anesthesiology 2002 Jun; 96(6): 1305–9PubMedCrossRefGoogle Scholar
  83. 83.
    Rasmussen GL, Steckner K, Hogue C, et al. Intravenous parecoxib sodium for acute pain after orthopedic knee surgery. Am J Orthop 2002 Jun; 31(6): 336–43PubMedGoogle Scholar
  84. 84.
    Barton SF, Langeland FF, Snabes MC, et al. Efficacy and safety of intravenous parecoxib sodium in relieving postoperative pain following gynecologic laparotomy surgery. Anesthesiology 2002; 97: 306–14PubMedCrossRefGoogle Scholar
  85. 85.
    Bikhazi GB, Snabes MC, Bajwa ZH, et al. A clinical trial demonstrates the analgesic activity of intravenous parecoxib sodium compared with ketorolac or morphine after gynecologic surgery with laparotomy. Am J Obstet Gynecol 2004; 191(4): 1183–91PubMedCrossRefGoogle Scholar
  86. 86.
    Ott E, Nussmeier NA, Duke PC, et al. Efficacy and safety of the cyclooxygenase 2 inhibitors parecoxib and valdecoxib in patients undergoing coronary artery bypass surgery. J Thoracic Cardiovasc Surg 2003; 125(6): 1481–92CrossRefGoogle Scholar
  87. 87.
    Bresalier R, Reicin A, Woodcock J. The APPROVe study: what we should learn from VIOXX withdrawal. Curr Hypertens Rep 2005; 7: 41–3CrossRefGoogle Scholar
  88. 88.
    Bombardier C, Laine L, Reicin A, et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis: VIGOR Study Group. N Engl J Med 2000; 343(21): 1520–8PubMedCrossRefGoogle Scholar
  89. 89.
    Schmedtje JF, Ji YS, Liu WL, et al. Hypoxia induces cyclooxygenase-2 via the NF-kappaB p65 transcription factor in human vascular endothelial cells. J Biol Chem 1997; 272(1): 601–8PubMedCrossRefGoogle Scholar
  90. 90.
    Clark DWJ, Layton D, Shakir SAW. Do some inhibitors of COX-2 increase the risk of thromboembolic events? Linking pharmacology with pharmacoepidemiology. Drug Saf 2004; 27: 427–56PubMedCrossRefGoogle Scholar
  91. 91.
    Kasliwal R, Layton D, Harris S. A comparison of reported gastrointestinal and thromboembolic events between rofecoxib and celecoxib using observational data. Drug Saf 2005; 28(9): 803–16PubMedCrossRefGoogle Scholar
  92. 92.
    Layton D, Wilton LV, Shakir SA. Safety profile of celecoxib as used in general practice in England: results of a prescription-event monitoring study. Eur J Clinical Pharmacol 2004 Sept; 60(7): 489–501CrossRefGoogle Scholar
  93. 93.
    Ferreira SH, Lorenzetti BB, Correa FM. Central and peripheral antialgesic action of aspirin-like drugs. Eur J Pharmacol 1978; 53(1): 39–48PubMedCrossRefGoogle Scholar
  94. 94.
    Romsing J, Moiniche S, Ostergaard D, et al. Local infiltration with NSAIDs for postoperative analgesia: evidence for a peripheral analgesic action. Acta Anaesthesiol Scand 2000; 44(6): 672–83PubMedCrossRefGoogle Scholar
  95. 95.
    Raffa RB, Friderichs E, Reimann W. Opioid and non-opioids components independently contribute to the mechanisms of action of tramadol: an atypical opioid analgesic. J Pharmacol Exp Ther 1992; 260: 275–85PubMedGoogle Scholar
  96. 96.
    Horishita T, Minami K, Uezono Y, et al. The tramadol metabolite, O-desmethyl tramadol. Pharmacology 2006; 77(2): 93–9PubMedCrossRefGoogle Scholar
  97. 97.
    Wilder-Smith CH, Bettiga A. The analgesic tramadol has minimal effect on gastrointestinal motor function. Br J Clin Pharmacol 1997; 43: 71–5PubMedCrossRefGoogle Scholar
  98. 98.
    Moore RA, McQuay HJ. Single-patient data meta-analysis of 3453 postoperative patients: oral tramadol versus placebo, codeine and combination analgesics. Pain 1997; 69(3): 287–94PubMedCrossRefGoogle Scholar
  99. 99.
    McQuay H, Edwards J. Meta-analysis of single dose oral tramadol plus acetaminophen in acute postoperative pain. Eur J Anaesthesiol 2003; 28 Suppl.: 19–22Google Scholar
  100. 100.
    Smith AB, Ravikumar TS, Kamin M, et al. Combination tramadol plus acetaminophen for postsurgical pain. Am J Surg 2004; 187(4): 521–7PubMedCrossRefGoogle Scholar
  101. 101.
    Snijdelaar DG, Cornelisse HB, Schmid RL, et al. A randomised, controlled study of peri-operative low dose s(+)-ketamine in combination with postoperative patient-controlled s(+)- ketamine and morphine after radical prostatectomy. Anaesthesia 2004; 59(3): 222–8PubMedCrossRefGoogle Scholar
  102. 102.
    Reeves M, Lindholm DE, Myles PS. Adding ketamine to morphine for patient-controlled analgesia after major abdominal surgery. Anesth Analg 2001; 93: 116–20PubMedCrossRefGoogle Scholar
  103. 103.
    Menigaux C, Guignard B, Fletcher D, et al. Intraoperative small-dose ketamine enhances analgesia after outpatient knee arthroscopy. Anesth Analg 2001; 93(3): 606–12PubMedCrossRefGoogle Scholar
  104. 104.
    Kwok RF, Lim J, Chan MT, et al. Preoperative ketamine improves postoperative analgesia after gynecologic laparoscopic surgery. Anesth Analg 2004; 98(4): 1044–9PubMedCrossRefGoogle Scholar
  105. 105.
    Kararmaz A, Kaya S, Karaman H, et al. Intraoperative intravenous ketamine in combination with epidural analgesia: postoperative analgesia after renal surgery. Anesth Analg 2003; 97(4): 1092–6PubMedCrossRefGoogle Scholar
  106. 106.
    Aida S, Yamakura T, Baba H, et al. Preemptive analgesia by intravenous low-dose ketamine and epidural morphine in gastrectomy: a randomized double-blind study. Anesthesiology 2000; 92(6): 1624–30PubMedCrossRefGoogle Scholar
  107. 107.
    Urban L, Thompson SW, Dray A. Modulation of spinal excitability: co-operation between neurokinin and excitatory amino acid neurotransmitters. Trends Neurosci 1994 Oct; 17(10): 432–8PubMedCrossRefGoogle Scholar
  108. 108.
    Weinbroum AA. A single small dose postoperative ketamine provides rapid and sustained improvement in morphine analgesia in the presence of morphine-resistance pain. Anesth Analg 2003; 96: 789–95PubMedCrossRefGoogle Scholar
  109. 109.
    Adam F, Chauvin M, Manoir BD, et al. Small dose ketamine infusion improves postoperative analgesia and rehabilitation after knee arthroplasty. Anesth Analg 2005; 100: 475–80PubMedCrossRefGoogle Scholar
  110. 110.
    Argiriadou H, Himmelseher S, Papagiannopoulou P. Improvement of pain treatment after major abdominal surgery by intravenous S+ ketamine. Anesth Analg 2004 May; 98(5): 1413–8PubMedCrossRefGoogle Scholar
  111. 111.
    Subramaniam B, Subramaniam K, Pawar DK. Preoperative epidural ketamine in combination with morphine does not have a clinically relevant intra- and postoperative opioid-sparing effect. Anesth Analg 2001 Nov; 93(5): 1321–6PubMedCrossRefGoogle Scholar
  112. 112.
    Tan PH, Kuo MC, Kao PF, et al. Patient controlled epidural analgesia with morphine or morphine plus ketamine for postoperative pain relief. Eur J Anaesthesiol 1999; 16(12): 820–5PubMedGoogle Scholar
  113. 113.
    Subramaniam K, Subramaniam B, Steinbrook RA. Ketamine as adjuvant analgesic to opioids: a quantitative and qualitative systematic review. Anesth Analg 2004; 99(2): 482–95PubMedCrossRefGoogle Scholar
  114. 114.
    Wong CS, Liaw WJ, Tung CS, et al. Ketamine potentiates analgesic effect of morphine in postoperative epidural pain control. Region Anesth 1996; 21(6): 534–41Google Scholar
  115. 115.
    Azevedo VM, Lauretti GR, Pereira NL, et al. Transdermal ketamine as an adjuvant for postoperative analgesia after abdominal gynecological surgery using lidocaine epidural blockade. Anesth Analg 2000; 91(6): 1479–82PubMedCrossRefGoogle Scholar
  116. 116.
    Taura P, Fuster J, Blasi A, et al. Postoperative pain relief after hepatic resection in cirrhotic patients: the efficacy of a single small dose of ketamine plus morphine epidurally. Anesth Analg 2003 Feb; 96(2): 475–80PubMedCrossRefGoogle Scholar
  117. 117.
    Bhana N, Goa KL, McClellan KJ. Dexmedetomidine. Drugs 2000; 59(2): 263–8PubMedCrossRefGoogle Scholar
  118. 118.
    Sites BD, Beach M, Biggs R. Intrathecal clonidine added to a bupivacaine-morphine spinal anesthetic improves postoperative analgesia for total knee arthroplasty. Anesth Analg 2003; 96: 1083–8PubMedCrossRefGoogle Scholar
  119. 119.
    Paech MJ, Pavy TJ, Orlikowski CE, et al. Postoperative epidural infusion: a randomized, double-blind, dose-finding trial of clonidine in combination with bupivacaine and fentanyl. Anesth Analg 1997; 84(6): 1323–8PubMedGoogle Scholar
  120. 120.
    Eisenach JC, Detweller D, Hood D. Hemodynamic and analgesic actions of epidurally administered clonidine. Anesthesiology 1993; 78(2): 277–87PubMedCrossRefGoogle Scholar
  121. 121.
    Szumita PM, Baroletti SA, Anger KE. Sedation and analgesia in the intensive care unit: evaluating the role of dexmedetomidine. Am J Health Syst Pharm 2007 Jan 1; 64(1): 37–44PubMedCrossRefGoogle Scholar
  122. 122.
    Gurbet A, Basaqan-Moqol E, Turker G. Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements. Can J Anaesth 2006 July; 53(7): 646–52PubMedCrossRefGoogle Scholar
  123. 123.
    Wahlander S, Frumento RJ, Wagener G. A prospective, double-blind, randomized, placebo-controlled study of dexmedetomidine as an adjunct to epidural analgesia after thoracic surgery. J Cardiothorac Vasc Anesth 2005 Oct; 19(5): 630–5PubMedCrossRefGoogle Scholar
  124. 124.
    Yeager MP, Glass DD, Neff RK, et al. Epidural anesthesia and analgesia in high-risk surgical patients. Anesthesiology 1987; 66(6): 729–36PubMedCrossRefGoogle Scholar
  125. 125.
    Tuman KJ, McCarthy RJ, March RJ, et al. Effects of epidural anesthesia and analgesia on coagulation and outcome after major vascular surgery. Anesth Analg 1991; 73(6): 696–704PubMedCrossRefGoogle Scholar
  126. 126.
    Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 2000; 321(7275): 1493PubMedCrossRefGoogle Scholar
  127. 127.
    Fillinger MP, Yeager MP, Dodds TM, et al. Epidural anesthesia and analgesia: effects on recovery from cardiac surgery. J Cardiothor Vasc Anesth 2002; 16(1): 15–20CrossRefGoogle Scholar
  128. 128.
    Beattie W, Badner N, Choi P. Epidural analgesia reduces postoperative myocardial infarction: a meta-analysis. Anesth Analg 2001; 93: 853–8PubMedCrossRefGoogle Scholar
  129. 129.
    Ballantyne JC, Carr DB, deFerranti S, et al. The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg 1998; 86(3): 598–612PubMedGoogle Scholar
  130. 130.
    Rigg JA, Jamrozik K, Myles PS. Epidural anesthesia and analgesia and outcome of major surgery: a randomised trial. Lancet 2002; 359: 1276–82PubMedCrossRefGoogle Scholar
  131. 131.
    Choi PT, Bhandari M, Scott J. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database Syst Rev 2003; (3): CD003071Google Scholar
  132. 132.
    Nishimori M, Ballantyne JC, Low JHS. Epidural pain relief versus systemic opioid-based pain relief for abdominal aortic surgery. Cochrane Database Syst Rev 2006; (3): CD005059Google Scholar
  133. 133.
    Park WY, Thompson JS, Lee KK. Effect of Epidural anesthesia and analgesia on perioperative outcome: a randomised, controlled Veterans Affairs cooperative study. Ann Surg 2001; 234: 560–71PubMedCrossRefGoogle Scholar
  134. 134.
    Werawatganon T, Charuluxanun S. Patient controlled intravenous opioid analgesia versus continuous epidural analgesia for pain after intra-abdominal surgery. Cochrane Database Syst Rev 2004; (3): CD004088Google Scholar
  135. 135.
    Jorgensen H, Wetterslev J, Moiniche S, et al. Epidural local anesthetics versus opioid based regimens on postoperative gastrointestinal paralysis, PONV and pain after abdominal surgery. Cochrane Database Syst Rev 2001; (1): CD001883Google Scholar
  136. 136.
    Lonnqvist PA. Adjuncts to caudal block in children: quo vadis. Br J Anaesth 2005; 95(4): 431–3PubMedCrossRefGoogle Scholar
  137. 137.
    Rosenberg AG. Anesthesia and analgesia protocols for total knee arthroplasty. Am J Orthop 2006 Jul; 35(7 Suppl.): 23–6PubMedGoogle Scholar
  138. 138.
    Lee A, Simpson D, Whitfield A, et al. Postoperative analgesia by continuous extradural infusion of bupivacaine and diamorphine. Br J Anaesth 1988; 60(7): 845–50PubMedCrossRefGoogle Scholar
  139. 139.
    Ready L. Acute pain: lessons learned from 25000 patients. Reg Anesth Pain Med 1999; 24: 499–505PubMedGoogle Scholar
  140. 140.
    Moiniche S, Mikkelsen S, Wetterslev J, et al. A qualitative systematic review of incisional local anaesthesia for postoperative pain relief after abdominal operations. Br J Anaesth 1998; 81(3): 377–83PubMedCrossRefGoogle Scholar
  141. 141.
    Tverskoy M, Oren M, Dashkovsky I, et al. Ketamine enhances local anesthetic and analgesic effects of bupivacaine by peripheral mechanism: a study in postoperative patients. Neurosci Lett 1996; 215: 5–8PubMedCrossRefGoogle Scholar
  142. 142.
    Dauri M, Polzoni M, Fabbi E, et al. Comparison of epidural, continuous femoral block and intraarticular analgesia after anterior cruciate ligament reconstruction. Acta Anaesthesiol Scand 2003; 47(1): 20–5PubMedCrossRefGoogle Scholar
  143. 143.
    Dal D, Tetik O, Altunkaya H, et al. The efficacy of intraarticular ketamine for postoperative analgesia in outpatient arthroscopic surgery. Arthroscopy 2004; 20(3): 300–5PubMedCrossRefGoogle Scholar
  144. 144.
    Calmet J, Esteve C, Boada S, et al. Analgesic effect of intraarticular ketorolac in knee arthroscopy: comparison of morphine and bupivacaine. Knee Surg Sports Traumatol Arthrosc 2004 Nov; 12(6): 552–5PubMedCrossRefGoogle Scholar
  145. 145.
    Reuben SS, Connelly NR. Postoperative analgesia for outpatient arthroscopic knee surgery with intraarticular bupivacaine and ketorolac. Anesth Analg 1995; 80(6): 1154–7PubMedGoogle Scholar
  146. 146.
    Moiniche S, Mikkelsen S, Wetterslev J, et al. A systematic review of intra-articular local anesthesia for postoperative pain relief after arthroscopic knee surgery. Reg Anesth Pain Med 1999; 24(5): 430–7PubMedGoogle Scholar
  147. 147.
    Stein C, Yassouridis A. Peripheral morphine analgesia. Pain 1997; 71: 119–21PubMedCrossRefGoogle Scholar
  148. 148.
    Stein C. Opioid receptors on peripheral sensory neurons. Adv Exp Med Biol 2003; 521: 69–76PubMedGoogle Scholar
  149. 149.
    Gupta A, Bodin L, Holmstrom B, et al. A systematic review of the peripheral analgesic effects of intraarticular morphine. Anesth Analg 2001; 93(3): 761–70PubMedCrossRefGoogle Scholar
  150. 150.
    Reuben SS, Connelly NR. Postarthroscopic meniscus repair analgesia with intraarticular ketorolac or morphine. Anesth Analg 1996; 82(5): 1036–9PubMedGoogle Scholar
  151. 151.
    Gupta A, Axelsson K, Allvin R, et al. Postoperative pain following knee arthroscopy: the effects of intra-articular ketorolac and/or morphine. Reg Anesth Pain Med 1999; 24(3): 225–30PubMedGoogle Scholar
  152. 152.
    Yang LC, Chen LM, Wang CJ. Postoperative analgesia by intra-articular neostigmine in patients undergoing knee arthroscopy. Anesthesiology 1998; 88: 334–9PubMedCrossRefGoogle Scholar
  153. 153.
    Lauretti GR, de Oliveira R, Perez MV. Postoperative analgesia by intra-articular and epidural neostigmine following knee surgery. J Clin Anesth 2000; 12: 444–8PubMedCrossRefGoogle Scholar
  154. 154.
    Gentili M, Juhel A, Bonnet F. Peripheral analgesic effect of intra-articular clonidine. Pain 1996; 64(3): 593–6PubMedCrossRefGoogle Scholar
  155. 155.
    White PF, Issioui T, Skrivanek GD, et al. The use of a continuous popliteal sciatic nerve block after surgery involving the foot and ankle: does it improve the quality of recovery? Anesth Analg 2003; 97(5): 1303–9PubMedCrossRefGoogle Scholar
  156. 156.
    Buckenmaier CC, Klein SM, Nielsen KC, et al. Continuous paravertebral catheter and outpatient infusion for breast surgery [published erratum appears in Anesth Analg 2004 Jan; 98 (1): 101]. Anesth Analg 2003; 97(3): 715–7PubMedCrossRefGoogle Scholar
  157. 157.
    Chelly JE, Greger J, Gebhard R, et al. Continuous femoral blocks improve recovery and outcome of patients undergoing total knee arthroplasty. J Arthro 2001; 16(4): 436–45CrossRefGoogle Scholar
  158. 158.
    Singelyn FJ, Aye F, Gouverneur JM. Continuous popliteal sciatic nerve block: an original technique to provide postoperative analgesia after foot surgery. Anesth Analg 1997; 84(2): 383–6PubMedGoogle Scholar
  159. 159.
    Chelly JE, Greger J, Al Samsam T, et al. Reduction of operating and recovery room times and overnight hospital stays with interscalene blocks as sole anesthetic technique for rotator cuff surgery. Minerva Anestesiol 2001; 67(9): 613–9PubMedGoogle Scholar
  160. 160.
    Richman JM, Liu SS, Courpas G. Does continuous peripheral nerve block provide superior pain control to opioids? A meta-analysis. Anesth Analg 2006; 102: 248–57PubMedCrossRefGoogle Scholar
  161. 161.
    Murphy DB, McCartney CJ, Chan VW. Novel analgesic adjuncts for brachial plexus block: a systematic review. Anesth Analg 2000; 90(5): 1122–8PubMedCrossRefGoogle Scholar
  162. 162.
    Picard PR, Tramer MR, McQuay HJ, et al. Analgesic efficacy of peripheral opioids (all except intra-articular): a qualitative systematic review of randomised controlled trials. Pain 1997; 72(3): 309–18PubMedCrossRefGoogle Scholar
  163. 163.
    Candido KD, Franco CD, Khan MA. Buprenorphine added to the local anesthetic for brachial plexus block to provide post-operative analgesia in outpatients. Reg Anesth Pain Med 2001; 26(4): 352–6PubMedGoogle Scholar
  164. 164.
    Julius D, Basbaum AI. Molecular mechanisms of nociception. Nature Biotech 2001; 413: 203–10CrossRefGoogle Scholar
  165. 165.
    Perkins FM, H K. Chronic pain as an outcome of surgery: a review of predictive factors. Anesthesiology 2000; 93: 1123–33PubMedCrossRefGoogle Scholar
  166. 166.
    Macrae WA. Chronic pain after surgery. Br J Anaesth 2001; 87: 88–98PubMedCrossRefGoogle Scholar
  167. 167.
    Wu CT, Yeh CC, Yu JC, et al. Pre-incisional epidural ketamine, morphine and bupivacaine combined with epidural and general anaesthesia provides pre-emptive analgesia for upper abdominal surgery. Acta Anaesthesiol Scand 2000 Jan; 44(1): 63–8PubMedCrossRefGoogle Scholar
  168. 168.
    Weinbroum AA, Lalayev G, Yashar T, et al. Combined preincisional oral dextromethorphan and epidural lidocaine for postoperative pain reduction and morphine sparing: a randomised double-blind study on day-surgery patients. Anaesthesia 2001 Jul; 56(7): 616–22PubMedCrossRefGoogle Scholar
  169. 169.
    Ke RWM, Portera SGM, Bagous WM, et al. A randomized, double-blinded trial of preemptive analgesia in laparoscopy. Obstet Gynecol 1998 Dec; 92(6): 972–5PubMedCrossRefGoogle Scholar
  170. 170.
    Papaziogas B, Argiriadou H, Papagiannopoulou P, et al. Preincisional intravenous low dose ketamine and local infiltration with ropivacaine reduces postoperative pain after laparoscopic cholecystectomy. Surg Endosc 2001 Sep; 15(9): 1030–3PubMedCrossRefGoogle Scholar
  171. 171.
    Ong KS, Seymour RA. Evidence based medicine approach to pre-emptive analgesia. Am J Pain Manage 2003; 13(4): 158–72Google Scholar
  172. 172.
    Katz J, Schmid R, Snijdelaar DG. Pre-emptive analgesia using intravenous fentanyl plus low dose ketamine for radical prostatectomy under general anesthesia does not produce short term or longterm reductions in pain or analgesic use. Pain 2004; 110(3): 707–18PubMedCrossRefGoogle Scholar
  173. 173.
    Katz J, McCartney CJ. Current status of pre-emptive analgesia. Curr Opinion Anesthesiol 2004; 15(4): 435–41CrossRefGoogle Scholar
  174. 174.
    Salonen A, Kokki H, Tuovinen K. I.V. ketoprofen for analgesia after tonsillectomy: comparison of pre- and post-operative administration. Br J Anaesth 2001 Mar; 86(3): 377–81Google Scholar
  175. 175.
    Kilickan L, Toker K. The effect of pre-emptive intravenous morphine on postoperative analgesia and surgical stress response. Panminerva Med 2001; 43: 171–5PubMedGoogle Scholar
  176. 176.
    Ong KSD, Seymour RAD, Yeo JFD, et al. The efficacy of preoperative versus postoperative rofecoxib for preventing acute postoperative dental pain: a prospective randomized crossover study using bilateral symmetrical oral surgery. Clin J Pain 2005; 21(6): 536–42PubMedCrossRefGoogle Scholar
  177. 177.
    Reuben SS, Vieira P, Faruqi S, et al. Local administration of morphine for analgesia after iliac bone graft harvest. Anesthesiology 2001; 95(2): 390–4PubMedCrossRefGoogle Scholar
  178. 178.
    Nguyen A, Girard F, Boudreault D. Scalp nerve blocks decrease the severity of pain after craniotomy. Anesth Analg 2001; 93: 1272–6PubMedCrossRefGoogle Scholar
  179. 179.
    Moiniche S, Kehlet H, Dahl JB. A qualitative and quantitative systematic review of pre-emptive analgesia for postoperative pain: the role of timing of analgesia. Anesthesiology 2002; 96: 725–41PubMedCrossRefGoogle Scholar
  180. 180.
    Richards JT, Read JR, Chambers WA. Epidural anaesthesia as a method of pre-emptive analgesia for abdominal hysterectomy. Anaesthesia 1998; 53: 296–8PubMedCrossRefGoogle Scholar
  181. 181.
    Dahl V, Raeder JC, Erno PE, et al. Pre-emptive effect of preincisional versus post-incisional infiltration of local anaesthesia on children undergoing hernioplasty. Acta Anaesthesiol Scand 1996 Aug; 40(7): 847–51PubMedCrossRefGoogle Scholar
  182. 182.
    Updike GM, Manolitsas TP, Cohn DE, et al. Pre-emptive analgesia in gynecologic surgical procedures: preoperative wound infiltration with ropivacaine in patients who undergo laparotomy through a midline vertical incision. Am J Obstet Gynecol 2003 Apr; 188(4): 901–5PubMedCrossRefGoogle Scholar
  183. 183.
    Yaksh T, Reddy S. Studies in the primate on the analgesic effect associated with intrathecal actions of opiates, alpha-adrenergic agonists and baclofen. Anesthesiology 1981; 54: 451–67PubMedCrossRefGoogle Scholar
  184. 184.
    Gee NS, Brown JP, Dissanyake VU. The novel anticonvulsant drug, gabapentin binds to the alpha 2 delta subunit of a calcium channel. J Biol Chem 1996; 271: 5768–76PubMedCrossRefGoogle Scholar
  185. 185.
    Dahl JB, Mathiesen O, Moiniche S. Protective premedication: an option with gabapentin and related drugs? Acta Anaesthes Scand 2004; 48(9): 1130–5CrossRefGoogle Scholar
  186. 186.
    Turan A, Kaya G, Karamanlioglu B, et al. Effect of oral gabapentin on postoperative epidural analgesia. Br J Anaesth 2006 Feb; 96(2): 242–6PubMedCrossRefGoogle Scholar
  187. 187.
    Pandey CK, Priye S, Singh S. Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirements in laparoscopic cholecystectomy. Can J Anaesth 2004; 51: 358–63PubMedCrossRefGoogle Scholar
  188. 188.
    Turan A, Karamanlioglu B, Memis D. The analgesic effects of gabapentin after total abdominal hysterectomy. Anesth Analg 2004; 98(5): 1370–3PubMedCrossRefGoogle Scholar
  189. 189.
    Rorarius MG, Mennander S, Souminen P. Gabapentin for the prevention of postoperative pain after vaginal hysterectomy. Pain 2004; 110: 175–81PubMedCrossRefGoogle Scholar
  190. 190.
    Turan A, Karamanlioglu B, Memis D. Analgesic effects of gabapentin after spinal surgery. Anesthesiology 2004; 100: 935–8PubMedCrossRefGoogle Scholar
  191. 191.
    Turan A, Memis D, Karamanlioglu B. The analgesic effects of gabapentin in monitored anesthesia care for ear-nose-throat surgery. Anesth Analg 2004; 99: 375–8PubMedCrossRefGoogle Scholar
  192. 192.
    Dirks J, Fredensborg BB, Christensen D, et al. A randomized study of the effects of single-dose gabapentin versus placebo on postoperative pain and morphine consumption after mastectomy. Anesthesiology 2002; 97(3): 560–4PubMedCrossRefGoogle Scholar
  193. 193.
    Dierking G, Duedahl TH, Rasmussen ML, et al. Effects of gabapentin on postoperative morphine consumption and pain after abdominal hysterectomy: a randomized, double-blind trial. Acta Anaesthes Scand 2004; 48(3): 322–7CrossRefGoogle Scholar
  194. 194.
    Ho KY, Gan TJ, Habib AS. Gabapentin and postoperative pain: a systematic review of randomised controlled trials. Pain 2006 Dec; 126(1–3): 91–101PubMedCrossRefGoogle Scholar
  195. 195.
    Gilron I, Orr E, Tu D, et al. A placebo controlled randomised clinical trial of perioperative administration of gabapentin, rofecoxib and their combination for spontaneous and movement-evoked after abdominal hysterectomy. Pain 2005; 113(1–2): 191–200PubMedCrossRefGoogle Scholar
  196. 196.
    Reuben SS, Buvanendran A, Kroin JS, et al. The analgesic efficacy of celecoxib, pregabalin and their combination for spinal fusion surgery. Anesth Analg 2006 Nov; 103(5): 1271–7PubMedCrossRefGoogle Scholar
  197. 197.
    Fassoulaki A, Patris K, Sarantopoulos C, et al. The analgesic effect of gabapentin and mexiletine after breast surgery for cancer. Anesth Analg 2002; 95(4): 985–91PubMedGoogle Scholar
  198. 198.
    Schimmer BP, Parker KL. Adrenocorticotrophic hormone: inhibitors of the synthesis and actions of adrenocortical hormones. In: Goodman and Gilman’s the pharmacological basis of therapeutics. New York: McGraw Publishing, 1996: 1459-81Google Scholar
  199. 199.
    Svensson CI, Yaksh TL. The spinal phospholipase-cyclooxygenase-prostanoid cascade in nociceptive processing. Annu Rev Pharmacol Toxicol 2002; 42: 553–83PubMedCrossRefGoogle Scholar
  200. 200.
    Steward DL, Welge JA, Myer CM. Steroids for improving recovery following tonsillectomy in children. Cochrane Database Sys Rev 2003; (1): CD003997Google Scholar
  201. 201.
    Skjelbred P, Lokken P. Reduction of pain and swelling by a corticosteroid injected 3 hours after surgery. Euro J Clin Pharmacol 1982; 23(2): 141–6CrossRefGoogle Scholar
  202. 202.
    Bisgaard T, Klarskov B, Kehlet H, et al. Preoperative dexamethasone improves surgical outcome after laparoscopic cholecystectomy: a randomized double-blind placebo-controlled trial. Ann Surg 2003; 238(5): 651–60PubMedCrossRefGoogle Scholar
  203. 203.
    Romundstad L, Breivik H, Niemi G, et al. Methylprednisolone intravenously 1 day after surgery has sustained analgesic and opioid-sparing effects. Acta Anaesthes Scand 2004; 48(10): 1223–31CrossRefGoogle Scholar
  204. 204.
    Schmidt BL, Gear RW, Levine JD. Response of neuropathic trigeminal pain to the combination of low-dose nalbuphine plus naloxone in humans. Neurosci Lett 2003; 343(2): 144–6PubMedCrossRefGoogle Scholar
  205. 205.
    Liu KS, Hu OY, Ho ST, et al. Antinociceptive effect of a novel long-acting nalbuphine preparation. Br J Anaesth 2004; 92(5): 712–5PubMedCrossRefGoogle Scholar
  206. 206.
    Shen KF, Crain SM. Ultra-low doses of naltrexone or etorphine increase morphine’s antinociceptive potency and attenuate tolerance/dependence in mice. Brain Res 1997; 757(2): 176–90PubMedCrossRefGoogle Scholar
  207. 207.
    Crain SM, Shen KF. Antagonists of excitatory opioid receptor functions enhance morphine’s analgesic potency and attenuate opioid tolerance/dependence liability. Pain 2000; 84(2–3): 121–31PubMedCrossRefGoogle Scholar
  208. 208.
    Gan TJ, Ginsberg B, Glass PS, et al. Opioid-sparing effects of a low-dose infusion of naloxone in patient-administered morphine sulfate. Anesthesiology 1997; 87(5): 1075–81PubMedCrossRefGoogle Scholar
  209. 209.
    Mehlisch DR. The combination of low dose of naloxone and morphine in patient-controlled (PCA) does not decrease opioid requirements in the postoperative period. Pain 2003; 101(1–2): 209–11PubMedCrossRefGoogle Scholar
  210. 210.
    Joshi GP, Duffy L, Chehade J, et al. Effects of prophylactic nalmefene on the incidence of morphine-related side effects in patients receiving intravenous patient-controlled analgesia. Anesthesiology 1999; 90(4): 1007–11PubMedCrossRefGoogle Scholar
  211. 211.
    Cepeda MS, Alvarez H, Morales O, et al. Addition of ultralow dose naloxone to postoperative morphine PCA: unchanged analgesia and opioid requirement but decreased incidence of opioid side effects. Pain 2004; 107(1–2): 41–6PubMedCrossRefGoogle Scholar
  212. 212.
    Bhatia A, Kashyap L, Pawar DK, et al. Effect of intraoperative magnesium infusion on perioperative analgesia in open cholecystectomy. J Clin Anesth 2004; 16(4): 262–5PubMedCrossRefGoogle Scholar
  213. 213.
    Tramer MR, Schneider J, Marti RA, et al. Role of magnesium sulfate in postoperative analgesia. Anesthesiology 1996; 84(2): 340–7PubMedCrossRefGoogle Scholar
  214. 214.
    McCartney CJ, Sinha A, Katz J. A qualitative systematic review of the role of N-methyl-D-aspartate receptor antagonists in preventive analgesia. Anesth Analg 2004; 98(5): 1385–400PubMedCrossRefGoogle Scholar
  215. 215.
    Comer AM, Lamb HM. Lidocaine patch 5%. Drugs 2000; 59(2): 245–9PubMedCrossRefGoogle Scholar
  216. 216.
    Gammaitoni AR, Alvarez NA, Galer BS. Safety and tolerability of the lidocaine patch 5%, a targeted peripheral analgesic: a review of the literature. J Clin Pharmacol 2003; 43(2): 111–7PubMedCrossRefGoogle Scholar
  217. 217.
    Chelly J. An iontophoretic, fentanyl HCL patient controlled transdermal system for acute postoperative pain management. Expert Opin Pharmocother 2005; 6(7): 1205–14CrossRefGoogle Scholar
  218. 218.
    Chelly JE, Grass J, Houseman TW, et al. The safety and efficacy of a fentanyl patient-controlled transdermal system for acute postoperative analgesia: a multicenter, placebo-controlled trial. Anesth Analg 2004; 98(2): 427–33PubMedCrossRefGoogle Scholar
  219. 219.
    Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995; 273(5): 408–12PubMedCrossRefGoogle Scholar
  220. 220.
    Carroll D, Tramer M, McQuay H, et al. Randomisation is important in studies with pain outcome: systematic review of TENS in acute postoperative pain. Br J Anaesth 1996; 77: 798–803PubMedCrossRefGoogle Scholar
  221. 221.
    Hamza M, White P, Hesham H, et al. Effect of the frequency of transcutaneous electrical stimulation on the postoperative analgesic requirement and recovery profile. Anesthesiology 1999; 91: 1232–8PubMedCrossRefGoogle Scholar
  222. 222.
    McQuay HJ, Moore RA. Postoperative analgesia and vomiting, with special reference to day-case surgery: a systematic review. Health Technol Assess 1998; 2(12): 1–236PubMedGoogle Scholar
  223. 223.
    Linton SJ. Applied relaxation as a method of coping with chronic pain: a therapists guide. Scand J Behav Ther 1982; 11: 161–74CrossRefGoogle Scholar
  224. 224.
    Seers K, Carroll D. Relaxation techniques for acute pain management: a systematic review. J Adv Nurs 1998; 27(3): 466–75PubMedCrossRefGoogle Scholar
  225. 225.
    Wang SM, Kulkarni L, Dolev J, et al. Music and preoperative anxiety: a randomized, controlled study. Anesth Analg 2002; 94(6): 1489–94PubMedGoogle Scholar
  226. 226.
    Nilsson U, Rawal N, Unosson M. A comparison of intraoperative or postoperative exposure to music: a controlled trial of the effects on postoperative pain. Anaesthesia 2003; 58(7): 699–703PubMedCrossRefGoogle Scholar
  227. 227.
    Fernandez E, Turk DC. The utility of cognitive coping strategies for altering pain perception: a meta-analysis. Pain 1989; 38(2): 123–35PubMedCrossRefGoogle Scholar
  228. 228.
    Cepeda MS, Carr DB, Lau J. Music for pain relief. Cochrane Database Syst Rev 2006 Apr 19; (2): CD004843Google Scholar
  229. 229.
    Wang B, Tang J, White PF, et al. Effect of the intensity of transcutaneous acupoint electrical stimulation on the postoperative analgesic requirement. Anesth Analg 1997; 85(2): 406–13PubMedGoogle Scholar
  230. 230.
    Ho CM, Hseu SS, Tsai SK, et al. Effect of P-6 acupressure on prevention of nausea and vomiting after epidural morphine for post-cesarean section pain relief. Acta Anaesthes Scand 1996; 40(3): 372–5CrossRefGoogle Scholar
  231. 231.
    Chernyak GV, Sessler DI. Perioperative acupuncture and related techniques. Anesthesiology 2005; 102(5): 1031–49, quiz 1078PubMedCrossRefGoogle Scholar
  232. 232.
    Cao X. Scientific bases of acupuncture analgesia. Acupuncture Electrother Res 2002; 27(1): 1–14Google Scholar
  233. 233.
    Han JS. Acupuncture and endorphins. Neurosci Lett 2004; 361(1–3): 258–61PubMedCrossRefGoogle Scholar
  234. 234.
    Kotani N, Hashimoto H, Sato Y, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anesthesiology 2001; 95(2): 349–56PubMedCrossRefGoogle Scholar
  235. 235.
    Sim CK, Xu PC, Pua HL, et al. Effects of electroacupuncture on intraoperative and postoperative analgesic requirement. Acupuncture Med 2002; 20(2–3): 56–65CrossRefGoogle Scholar
  236. 236.
    Meurisse M, Defechereux T, Hamoir E, et al. Hypnosis with conscious sedation instead of general anaesthesia? Applications in cervical endocrine surgery. Acta Chir Belg 1999 Aug; 99(4): 151–8PubMedGoogle Scholar
  237. 237.
    Faymonville ME, Fissette J, Mambourg PH. Hypnosis as adjunct therapy in conscious sedation for plastic surgery. Reg Anesth 1995 Mar; 20(2): 145–51PubMedGoogle Scholar
  238. 238.
    Lang EV, Benotsch EG, Fick LJ, et al. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet 2000; 335(9214): 1486–90CrossRefGoogle Scholar
  239. 239.
    Schupp CJ, Berbaum K, Berbaum M, et al. Pain and anxiety during interventional radiologic procedures: effect of patients’ state anxiety at baseline and modulation by nonpharmacologic analgesia adjuncts. J Vasc Interv Radiol 2005; 16(12): 1585–92PubMedCrossRefGoogle Scholar
  240. 240.
    Montgomery GH, David D, Winkel G, et al. The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis. Anesth Analg 2002; 94(6): 1639–45PubMedGoogle Scholar
  241. 241.
    Montgomery GH, Weltz CR, Seltz M, et al. Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. Int J Clin Exp Hypnosis 2002; 50(1): 17–32CrossRefGoogle Scholar
  242. 242.
    Melzack R, Germain M, Belanger E, et al. Positive intrasurgical suggestion fails to affect postsurgical pain. J Pain Symptom Manage 1996; 11(2): 103–7PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  1. 1.Department of AnesthesiologyDuke University Medical CenterDurhamUSA

Personalised recommendations