Dolor postoperatorio / Postoperative pain

Febrero 5, 2018. No. 2985

Nuevos enfoques en el tratamiento del dolor agudo postoperatorio N. Esteve Pérez , C. Sansaloni Perelló , M. Verd Rodríguez , H. Ribera Leclercy C. Mora Fernández Rev. Soc. Esp. del Dolor, Vol. 24, N.º 3, Mayo-Junio 2017 PDF Aspectos básicos del dolor postoperatorio y la analgesia multimodal preventiva Dr. Jorge Rosa-Díaz, Dr. Víctor Navarrete-Zuazo, Dra. Miosotis Díaz-Mendiondo Revista Mexicana de Anestesiología Volumen 37, No. 1, enero-marzo 2014 PDF 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. Wardhan R1, Chelly J2. Author information 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 PDF Safe Anaesthesia Worldwide Delivering safe anaesthesia to the world's poorest people Informes / Information World Congress on Regional Anesthesia & Pain Medicine April 19-21, 2018, New York City, USA Informes / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Bloqueos de nervios periféricos en dolor postoperatorio / Peripheral nerve blocks for postoperative pain

Agosto 12, 2017. No. 2778

Bloqueos de nervios periféricos en dolor postoperatorio. Retos y oportunidades Peripheral nerve blocks in the management of postoperative pain: challenges and opportunities. Joshi G1, Gandhi K2, Shah N3, Gadsden J4, Corman SL5. J Clin Anesth. 2016 Dec;35:524-529. doi: 10.1016/j.jclinane.2016.08.041. Epub 2016 Oct 20.Abstract Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures. cPNB has also been associated with a reduction in time to discharge readiness compared with sPNB. Risks of PNB, regardless of technique or block location, include vascular puncture and bleeding, nerve damage, and local anesthetic systemic toxicity. Site-specific complications include quadriceps weakness in patients receiving femoral nerve block, and pleural puncture or neuraxial blockade in patients receiving interscalene block. The major limitation of sPNB is the short (12-24 hours) duration of action. cPNB may be complicated by catheter obstruction, migration, and leakage of local anesthetic as well as accidental removal of catheters. Potential infectious complications of catheters, although rare, include local inflammation and infection. Other considerations for ambulatory cPNB include appropriate patient selection, education, and need for 24/7 availability of a health care provider to address any complications. The ideal PNB technique would have a duration of action that is sufficiently long to address the most intense period of postsurgical pain; should be associated with minimal risk of infection, neurologic complications, bleeding, and local anesthetic systemic toxicity; and should be easy to perform, convenient for patients, and easy to manage in the postoperative period. KEYWORDS: Multimodal analgesia; Peripheral nerve block; Postoperative pain PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information California Society of Anesthesiologists Reuniones / Events Informacion / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org