Avances recientes en el manejo del dolor agudo: comprensión de los mecanismos del dolor agudo, la prescripción de opiáceos y el papel de la terapia del dolor multimodal.
Recent advances in acute pain management: understanding the mechanisms of acute pain, the prescription of opioids, and the role of multimodal pain therapy.
F1000Res. 2017 Nov 29;6:2065. doi: 10.12688/f1000research.12286.1. eCollection 2017.
Abstract
In this review, we discuss advances in acute pain management, including the recent report of the joint American Pain Society and American Academy of Pain Medicine task force on the classification of acute pain, the role of psychosocial factors, multimodal pain management, new non-opioid therapy, and the effect of the "opioid epidemic". In this regard, we propose that a fundamental principle in acute pain managementis identifying patients who are most at risk and providing an "opioid free anesthesia and postoperative analgesia". This can be achieved by using a multimodal approach that includes regional anesthesia and minimizing the dose and the duration of opioid prescription. This allows prescribing medications that work through different mechanisms. We shall also look at the recent pharmacologic and treatment advances made in acute pain and regional anesthesia.
KEYWORDS: acute pain; multimodal therapy; pharmacogenetics; psychosocial factors
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