Preventive analgesia

Preventive analgesia is a practice aimed at reducing short- and long-term post-surgery pain. Activity in the body's pain signalling system during surgery produces "sensitization"; that is, it increases the intensity of post-operative pain. Reducing activity in the body's pain-signalling system by the use of analgesics before, during and immediately after surgery is thought to reduce subsequent sensitization, and consequently the intensity of post-surgery pain. The types of nerve activity targeted in preventive analgesia include pre-surgery pain, all pain-system activity caused during surgery, and pain produced post-surgery by damage and inflammation.[1] A person's assessment of pain intensity from standard experimental stimuli prior to surgery is correlated with the intensity of their post-surgery pain. Pain intensity immediately post-surgery is correlated with pain intensity on release from hospital, and correlated with the likelihood of experiencing chronic post-surgery pain.[1] Different medications such as pregabalin, acetaminophen, naproxen and dextromethorphan have been tried in studies about preemptive analgesia.[2][3] It is not known what causes some cases of acute post-surgery pain to become chronic long term problems but pain intensity in the short- and long-term post-operative period is correlated with the amount of pain system activity during and around the time of the surgery. It is not known whether reducing post-operative sensitization by the use of preventive analgesia will affect the likelihood of acute post-operative pain becoming chronic.[1]

References

  1. Katz J & Clarke H. Preventive analgesia and beyond: Current status, evidence and future directions. In: Macintyre PE, Walker SM & Rowbotham DJ. Acute Pain. London: Hodder Arnold; 2008. ISBN 978-0-340-94009-9. p. 154–198.
  2. Amiri, Hamid Reza et al. “Multi-Modal Preemptive Analgesia With Pregabalin, Acetaminophen, Naproxen, and Dextromethorphan in Radical Neck Dissection Surgery: A Randomized Clinical Trial.” Anesthesiology and Pain Medicine 6.4 (2016): e33526. PMC. Web. 23 Nov. 2017.
  3. Amiri, Hamidreza et al. “Three -Agent Preemptive Analgesia, Pregabalin-Acetaminophen-Naproxen, in Laparotomy for Cancer: A Randomized Clinical Trial.” Anesthesiology and Pain Medicine 7.2 (2017): e33269. PMC. Web. 23 Nov. 2017.
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