Preemptive Analgesia

  • A. Pasetto
  • A. Pasqualucci
  • E. Crimi
Conference paper


The data of the experimental studies suggested that preadministration of analgesic drugs and/or local anaesthetic prevents hyperplasticity of the central nervous system and thereby lower postoperative pain [1–8].


Postoperative Pain Abdominal Hysterectomy Morphine Consumption Preemptive Analgesia Secondary Hyperalgesia 
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  1. 1.
    Coderre TJ, Katz J, Vaccarino AL et al (1993) Contribution of central neuroplasticity to pathologic pain: Review of clinical and experimental evidence. Pain 52: 259–285PubMedCrossRefGoogle Scholar
  2. 2.
    Wall PD (1988) The prevention of postoperative pain. Pain 33: 289–290PubMedCrossRefGoogle Scholar
  3. 3.
    Woolf CJ, Wall PD (1986) Morphine-sensitive and morphine-insensitive actions of C-fibre input on the rat spinal cord. Neurosci Lett 64: 221–225PubMedCrossRefGoogle Scholar
  4. 4.
    McQuay HJ (1995) Pre-emptive analgesia: A systematic review of clinical studies. Ann Med 27: 249–256PubMedCrossRefGoogle Scholar
  5. 5.
    Dahl JB, Kehlet H (1993) The value of pre-emptive analgesia in the treatment of postoperative pain. Br J Anaesth 70: 434–439PubMedCrossRefGoogle Scholar
  6. 6.
    Kehlet H (1994) Postoperative pain relief-what is the issue? Br J Anaesth 72: 375–378PubMedCrossRefGoogle Scholar
  7. 7.
    Vaccarino AL, Melzack R (1992) Temporal processes of formalin pain: differential role of the cingulum bundle, fornix pathway and medial bulboreticular formation. Pain 44: 257–271CrossRefGoogle Scholar
  8. 8.
    Coderre TJ, Vaccarino AL, Melzack R (1990) Central nervous system plasticity in the tonic pain response to subcutaneous formalin injection. Brain Res 535: 155–158PubMedCrossRefGoogle Scholar
  9. 9.
    Kissin I (1996) Preemptive analgesia: Why its effect is not always obvious. Anesthesiology 84: 1015–1019PubMedCrossRefGoogle Scholar
  10. 10.
    Pasqualucci A, Colussi R, Lugano M (1997) Preemptive analgesia e anestetici locali. In: Braschi A, Chiaranda M, Gattinoni L et al (eds) Invited Lectures, SMART 1997, Milano. Springer, Milano, pp 48–57Google Scholar
  11. 11.
    Scheinin B, Kellokumpu I, Lindgren L et al (1995) Effect of intraperitoneal bupivacaine on pain after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 39: 195–198PubMedCrossRefGoogle Scholar
  12. 12.
    Turner GA, Chalkiadis G (1994) Comparison of preoperative with postoperative lignocaine infiltration on postoperative analgesic requirements. Br J Anaesth 72: 541–543PubMedCrossRefGoogle Scholar
  13. 13.
    Rice LJ, Pudimat MA, Hannalh RS (1990) Timing of caudal block placement in relation to surgery does not affect duration of postoperative analgesia in paediatric ambulatory patients. Can J Anaesth 37: 429–431PubMedCrossRefGoogle Scholar
  14. 14.
    Gunter JB, Forestner JE, Manley CB (1990) Caudal epidural anesthesia reduces blood loss during hypospadias repair. J Urol 144: 517–519PubMedGoogle Scholar
  15. 15.
    Dickenson AH, Sullivan AF (1987) Subcutaneous formalin-induced activity of dorsal horn neurones in rat: Differential response to an intrathecal opiate administered pre or post formalin. Pain 30: 349–360PubMedCrossRefGoogle Scholar
  16. 16.
    Yamamoto T, Yaksh TL (1992) Comparison of the antinociceptive effects of pre and posttreatment with intrathecal morphine and MK801, an NMDA antagonist, on the formalin test in the rat. Anesthesiology 77: 757–763PubMedCrossRefGoogle Scholar
  17. 17.
    Lascelles BDX, Waterman AE, Cripps PJ et al (1995) Central sensitization as a result of surgical pain: Investigation of the pre-emptive value of pethidine for ovariohysterectomy in the rat. Pain 62: 201–212PubMedCrossRefGoogle Scholar
  18. 18.
    Dallel R, Raboisson P, Clavelou P et al (1995) Evidence for a peripheral origin of the tonic nociceptive response to subcutaneous formalin. Pain 61: 11–16PubMedCrossRefGoogle Scholar
  19. 19.
    Yashpal K, Katz J, Coderre TJ (1996) Effects of preemptive or postinjury intrathecal local anesthesia on persistent nociceptive responses in rats. Confounding influences of peripheral inflammation and the general anesthetic regimen. Anesthesiology 84: 1119–1128PubMedCrossRefGoogle Scholar
  20. 20.
    LaMotte RH, Shain CN, Simone DA et al (1991) Neurogenic hyperalgesia: psychophysical studies of underlying mechanisms. J Neurophysiol 66: 190–211PubMedGoogle Scholar
  21. 21.
    Fletcher D, Kayser V, Guilbaud G (1996) Influence of timing of administration on the analgesic effect of bupivacaine infiltration in carrageenin-injected rats. Anesthesiology 84: 1129–1137PubMedCrossRefGoogle Scholar
  22. 22.
    Dahl JB, Brennum J, Arendt Nielsen L et al (1993) The effect of pre-versus postinjury infiltration with lidocaine on thermal and mechanical hyperalgesia after heat injury to the skin. Pain 53: 43–51PubMedCrossRefGoogle Scholar
  23. 23.
    Katz J, Kavanagh BP, Sandier AN et al (1992) Preemptive analgesia: clinical evidence of neuroplasticity contributing to postoperative pain. Anesthesiology 77: 439–446PubMedCrossRefGoogle Scholar
  24. 24.
    Richmond CE, Bromley LM, Woolf CJ (1993) Preoperative morphine pre-empts postoperative pain. Lancet 342: 73–75PubMedCrossRefGoogle Scholar
  25. 25.
    Mansfield M, James KS, Kinsella J (1996) Influence of dose and timing of administration of morphine on postoperative pain and analgesic requirements. Br J Anaesth 76: 358–361PubMedCrossRefGoogle Scholar
  26. 26.
    Fassoulaki A, Sarantopoulos C, Zotou M (1995) Preemptive opioid analgesia does not influence pain after abdominal hysterectomy. Can J Anaesth 42: 109–113PubMedCrossRefGoogle Scholar
  27. 27.
    Sarantopoulos C, Fassoulaki A (1996) Sufentanil does not preempt pain after abdominal hysterectomy. Pain 65: 273–276PubMedCrossRefGoogle Scholar
  28. 28.
    Mansfield M, Meikle R, Miller CA (1994) Trial of pre-emptive analgesia. Influence of timing of peroperative alfentanil on postoperative pain and analgesic requirements. Anaesthesia 49: 1091–1093PubMedCrossRefGoogle Scholar
  29. 29.
    Wilson RJT, Leith S, Jackson JB et al (1994) Pre-emptive analgesia from intravenous administration of opioids. No effects with alfentanil. Anaesthesia 49: 591–593PubMedCrossRefGoogle Scholar
  30. 30.
    Pryle BJ, Vanner RG, Enriquez N et al (1993) Can preemptive lumbar epidural blockade reduce postoperative pain following lower abdominal surgery? Anaesthesia 48: 120–123PubMedCrossRefGoogle Scholar
  31. 31.
    Katz J, Clairoux M, Kavanagh BP et al (1994) Pre-emptive lumbar epidural anaesthesia reduces postoperative pain and patient-controlled morphine consumption after lower abdominal surgery. Pain 59: 395–403PubMedCrossRefGoogle Scholar
  32. 32.
    Dierking GW, Dahl JB, Kanstrup J et al (1992) Effect of pre-vs postoperative inguinal field block on postoperative pain after herniorrhaphy. Br J Anaesth 68: 344–348PubMedCrossRefGoogle Scholar
  33. 33.
    Ejlersen E, Andersen HB, Eliasen K et al (1992) A comparison between preincisional and postincisional lidocaine infiltration and postoperative pain. Anesth Analg 74: 495–498PubMedCrossRefGoogle Scholar
  34. 34.
    Pasqualucci A, De Angelis V, Contardo R et al (1996) Preemptive analgesia. Intraperitoneal local anesthetic in laparoscopic cholecystectomy. A randomized, double-blind, placebo-controlled study. Anesthesiology 85: 11–20PubMedCrossRefGoogle Scholar
  35. 35.
    Dahl JB, Hansen BL, Hjortsf NC et al (1992) Influence of timing on the effect of continuous extradural analgesia with bupivacaine and morphine after major abdominal surgery. Br J Anaesth 69: 4–8PubMedCrossRefGoogle Scholar
  36. 36.
    Rockemann MG, Seeling W, Bischof C (1996) Prophylactic use of epidural mepivacaine/morphine, systemic diclofenac and metamizole reduces postoperative morphine consumption after major abdominal surgery. Anesthesiology 84: 1027–1034PubMedCrossRefGoogle Scholar
  37. 37.
    Espinet A, Henderson DJ, Faccenda KA et al (1996) Does pre-incisional thoracic extradural block combined with diclofenac reduce postoperative pain after abdominal hysterectomy? Br J Anaesth 76: 209–213PubMedCrossRefGoogle Scholar
  38. 38.
    Buggy DJ, Wall C, Carton G (1994) Preoperative or postoperative diclofenac for laparoscopic tubal ligation. Br J Anaesth 73: 767–770PubMedCrossRefGoogle Scholar
  39. 39.
    Vanlersberghe C, Lauwers MH, Camu F (1996) Preoperative ketorolac administration has no preemptive analgesic effect for minor orthopaedic surgery. Acta Anaesthesiol Scand 40: 948–952PubMedCrossRefGoogle Scholar
  40. 40.
    Fletcher D, Zetlaoui P, Monin S et al (1995) Influence of timing on the analgesic effect of intravenous ketorolac after orthopedic surgery. Pain 61: 291–297PubMedCrossRefGoogle Scholar
  41. 41.
    Murphy DF, Medley C (1993) Preoperative indomethacin for pain relief after thoracotomy: Comparison with postoperative indomethacin. Br J Anaesth 70: 298–300PubMedCrossRefGoogle Scholar
  42. 42.
    O’Connor TC, Abram SE (1995) Inhibition of nociception-induced spinal sensitization by anesthetic agents. Anesthesiology 82: 259–266PubMedCrossRefGoogle Scholar
  43. 43.
    Abram SE, Yaksh TL (1993) Morphine, but not inhalation anesthesia, blocks post-injury facilitation. The role of preemptive suppression of afferent transmission. Anesthesiology 78: 713–721PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1998

Authors and Affiliations

  • A. Pasetto
  • A. Pasqualucci
  • E. Crimi

There are no affiliations available

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