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Non-Enteral Pain Management

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Perioperative Pain Control: Tools for Surgeons

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Abstract

Providers must take patient-specific factors into account when creating perioperative pain management regimens. It is often inappropriate to utilize enteral formulations of analgesics perioperatively, so other routes of administration should be considered. Fortunately, many forms of non-enteral pain management options exist for use in multimodal analgesia regimens. Parenteral analgesia formulations bypass gastrointestinal absorption and are administered most commonly via intravenous route. Opioids are a traditional element of multimodal analgesia regimens and are available for parenteral administration. However, reducing opioid consumption is one of the goals of multimodal analgesia regimens, in which the addition of non-opioid components can reduce the potentially harmful effects of opioids. Non-opioid classes of drugs, such as nonsteroidal anti-inflammatory drugs, alpha-2 agonists, and NMDA receptor antagonists, are formulated for non-enteral administration and offer a variety of different mechanisms with which to decrease postoperative pain. Local anesthetics used in conjunction with these agents may also enhance postoperative analgesia and lead to better patient outcomes. When appropriate, opioids and local anesthetics can be administered into the epidural space to provide regional anesthesia. Overall, providers have many parenteral and localized pain management options available for use in the perioperative setting.

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Authors and Affiliations

  1. Summit Medical Group, Pharmacy Services, Berkeley Heights, NJ, USA

    Erin Maggie Jones

  2. Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA

    Gregory L. Barinsky

  3. Department of Otolaryngology – Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Andrew P. Johnson

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  1. Erin Maggie Jones
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  2. Gregory L. Barinsky
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  3. Andrew P. Johnson
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Editors and Affiliations

  1. Bergen Medical Associates, Emerson, NJ, USA

    Peter F. Svider

  2. Anesthesiology, Pain Medicine, Columbia University Irving Medical Center, New York, NY, USA

    Anna A. Pashkova

  3. Otolaryngology – Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Andrew P. Johnson

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Jones, E.M., Barinsky, G.L., Johnson, A.P. (2021). Non-Enteral Pain Management. In: Svider, P.F., Pashkova, A.A., Johnson, A.P. (eds) Perioperative Pain Control: Tools for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-030-56081-2_8

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  • DOI: https://doi.org/10.1007/978-3-030-56081-2_8

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