Opioid-based analgesia in the perioperative period can provide excellent pain control, but this approach exposes the patient to avoidable side effects and possible harm. Optimal analgesia, an approach that targets the fastest functional recovery with adequate pain control while minimizing side effects, can be achieved with opioid minimization. Many different options for nonopioid multimodal analgesia exist and have been shown to be efficacious, with certain modalities being more beneficial for specific surgeries. This review will present the evidence and practical tips for these management strategies.
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http://dx.doi.org/10.1016/j.anclin.2021.11.001 | DOI Listing |
Hernia
January 2025
Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1259, New York, NY, 10029, USA.
Purpose: While surgeons agree that perioperative field blocks should be performed for open inguinal hernia surgery, there lacks consensus in the minimally invasive context. Prior small-scale randomized trials study pain scores only up to 24 h postoperatively. Thus, we sought to investigate the analgesic benefits of a bupivacaine transversus abdominis plane (TAP) block in the first 4 postoperative days.
View Article and Find Full Text PDFNaunyn Schmiedebergs Arch Pharmacol
January 2025
Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S. Nagar, Punjab, India.
Neuropathic pain, a challenging condition often associated with diabetes, trauma, or chemotherapy, impairs patients' quality of life. Current treatments often provide inconsistent relief and notable adverse effects, highlighting the urgent need for safer and more effective alternatives. This review investigates marine-derived bioactive compounds as potential novel therapies for neuropathic pain management.
View Article and Find Full Text PDFAnn Med
December 2025
Department of Anesthesiology and Reanimation, Zonguldak Bülent Ecevit University Medicine Faculty, Zonguldak, Türkiye.
Background: Although both the lateral sagittal and costoclavicular approaches are applied at the cord level in the infraclavicular region, there is a major difference between the distributions of the two approaches. We aimed to investigate the effects of this different distribution on tissue perfusion and oxygenation.
Methods: Sixty patients undergoing elective elbow, forearm, wrist and hand surgery under infraclavicular brachial plexus block were included in the study.
J Hand Surg Am
January 2025
The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD. Electronic address:
The opioid epidemic has been a defining crisis in American health care. Many attempts to address the epidemic have focused on issues around opioid prescribing. Legislation at the state and federal levels has been passed; however, the results from these policies have been mixed.
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