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Acute Pain and Other Aspects of the Postoperative Period

  • N. Rawal
Conference paper

Abstract

Apart from humanitarian considerations, adequate pain relief can be expected to modulate nociception-induced responses such as metabolic response to surgery, autonomic and cardiovascular responses with adverse effects on organ function and muscle spasm. Obvious economic gains can be expected from early ambulation, reduced morbidity and shorter hospitalization in the postoperative period. Early alimentation and return to normal living pattern will facilitate patient rehabilitation.

Keywords

Epidural Analgesia Epidural Anaesthesia Postoperative Analgesia Epidural Morphine Epidural Block 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Breivik H (1994) Pre-emptive analgesia. Current Opinion in Anaesthesiology 7:458–461CrossRefGoogle Scholar
  2. 2.
    Bridenbaugh PO (1994) Pre-emptive analgesia — is it clinically relevant? (Editorial) Anesth Anaig 78:203–204CrossRefGoogle Scholar
  3. 3.
    Thorburn J, London JR, Vallance R (1980) Spinal and general anaesthesia in total hip replacement: frequency of deep vein thrombosis. Br J Anaesth 52:1117–1121PubMedCrossRefGoogle Scholar
  4. 4.
    Modig J, Borg T, Bagge L et al (1983) Role of extradural and of general anaesthesia in fibrinolysis and coagulation after total hip replacement. Br J Anaesth 55:625–629PubMedCrossRefGoogle Scholar
  5. 5.
    Hole A, Terjesen T, Breivik H (1980) Epidural versus general anaesthesia for total hip arthro-plasty in elderly patients. Acta Anaesthesiol Scand 24:279–287PubMedCrossRefGoogle Scholar
  6. 6.
    Manikian B, Cantineau JP, Bertrand M (1988) Improvement of diaphragmatic function by a thoracic extradural block after Upper abdominal surgery. Anesthesiology 68:379–386PubMedCrossRefGoogle Scholar
  7. 7.
    Thörn SE, Wattwil M, Näslund I (1992) Postoperative epidural morphine delays gastric emptying on the first day after cholecystectomy. Reg Anesth 17:91–94PubMedGoogle Scholar
  8. 8.
    Kirnö K, Friberg P, Grzegorcyzk A et al (1994) Thoracic epidural anaesthesia during coronary artery bypass surgery: effects on cardiac sympathetic activity, myocardial blood flow and metabolism, and central hemodynamics. Anesth Anaig 79:1075–1081Google Scholar
  9. 9.
    Grass JA, Sakima NT (1992) Epidural anaesthesia and analgesia results in shorter hospital stay after total abdominal hysterectomy. Reg Anesth 17:77–79Google Scholar
  10. 10.
    Cuscheri RJ, Morran CG, Howie JC et al (1985) Postoperative pain and pulmonary complications. Comparison of three analgesic regimes. Br J Surg 72:495–498CrossRefGoogle Scholar
  11. 11.
    Rawal N, Sjöstrand U, Christoffersson E et al (1984) Comparison of intramuscular and epidural morphine for postoperative analgesia in the grossly obese: influence on postoperative ambulation and pulmonary function. Anesth Anaig 63:583–592Google Scholar
  12. 12.
    Yeager MP, Glass DD, Neff RK et al (1987) Epidural anaesthesia and analgesia in high-risk surgical patients. Anesthesiology 66:729–736PubMedCrossRefGoogle Scholar
  13. 13.
    Tuman KJ, McCarthy RJ, March RJ et al (1991) Effects of epidural anaesthesia and analgesia on coagulation and outcome after major vascular surgery. Anesth Anaig 73:696–704Google Scholar
  14. 14.
    Christopherson R, Beattie C, Frank SM et al (1993) Peroperative morbidity in patients randomized to epidural or general anaesthesia for lower extremity vascular surgery. Anesthesiology 79:422–434PubMedCrossRefGoogle Scholar
  15. 15.
    Rawal N, Sjöstrand UH, Dahlström B et al (1982) Epidural morphine for postoperative pain relief: a comparative study with intramuscular narcotic and intercostal nerve block. Anesth Anaig 61:93–98Google Scholar
  16. 16.
    Jayr C, Thomas H, Rey A et al (1993) Postoperative pulmonary complications. Epidural analgesia using bupivacaine and Opioids versus parenteral Opioids. Anesthesiology 78: 666–678PubMedCrossRefGoogle Scholar
  17. 17.
    Rawal N, Allvin R (1995) Epidural and intrathecal Opioids for postoperative pain management in Europe — A 17-nation survey. Reg Anesth (in press)Google Scholar
  18. 18.
    Kehlet H (1994) Postoperative pain relief — what is the issue? (Editorial) Br J Anaesth 72: 375–378PubMedCrossRefGoogle Scholar
  19. 19.
    Schulze S, Sommer P, Bigler D et al (1992) Effect of combined prednisolone, epidural analgesia, and indomethacin on the systemic response after colonic surgery. Arch Surg 127: 325–331PubMedCrossRefGoogle Scholar
  20. 20.
    Mogensen T, Vegger P, Johnsson T et al (1992) Systemic piroxicam as an adjunct to combined epidural bupivacaine and morphine for postoperative pain relief — a double-blind study. Anesth Anaig 74:363–370Google Scholar
  21. 21.
    Bigler D, Moller J, Kamp-Jensen M et al (1992) Effect of piroxicam in addition to continuous thoracic epidural bupivacaine and morphine on postoperative pain and lung function after thoracotomy. Acta Anaesthesiol Scand 63:647–650CrossRefGoogle Scholar
  22. 22.
    Kavanagh BP, Katz J, Sandler AN et al (1994) Multimodal analgesia before thoracic surgery does not reduce postoperative pain. Br J Anaesth 73:184–189PubMedCrossRefGoogle Scholar
  23. 23.
    Bernard JM, Lagarde D, Souron R (1994) Balanced postoperative analgesia: effect of intravenous Clonidine on blood gases and pharmacokinetics of intravenous fentanyl. Anaesth Anaig 79:1126–1132Google Scholar
  24. 24.
    Rawal N, Berggren L (1994) Organization of acute pain Services — low cost model. Pain 57: 117–223PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 1997

Authors and Affiliations

  • N. Rawal

There are no affiliations available

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