Multimodal Analgesia for Perioperative Pain Management

Year 2024, Volume: 77 Issue: 2, 122 - 127, 12.08.2024

Fatma Candan Yerebakan Fatih Kurt , Kutluhan Çınbay , Neslihan Alkış

Abstract

Postoperative pain is an important problem which is a common condition in patients and can become chronic if left untreated. Ineffective pain
management in the postoperative period may increase stress response and may cause vital changes on endocrine, respiratory, cardiovascular,
gastrointestinal, and musculoskeletal systems and patient psychology. Side effects from the use of high-dose medication for pain management also
increases complications. Multimodal analgesia applications aim to reduce the side effects that may occur with the use of high doses of a single
agent by creating additive or synergistic effects by using analgesics with different mechanisms of action together. Therefore, protocols have been
developed that aim to minimize complications, eliminate pain, accelerate recovery, encourage early ambulation and thus reduce the length of
hospital stay. These include the Enhanced Recovery After Surgery protocols, which include multimodal analgesia and procedure-specific protocols.
The aim of this review is to highlight the most optimal patient and procedure-specific perioperative pain management strategies in the light of
available evidence.

Keywords

Postoperative pain , multimodal analgesia , ERAS , procedure-specific postoperative pain management

Ethical Statement

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Supporting Institution

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Project Number

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Thanks

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Perioperatif Ağrı Yönetiminde Multimodal Analjezi

Abstract

Postoperatif ağrı, hastalarda yaygın olarak görülen ve tedavi edilmediği takdirde kronikleşebilen önemli bir sorundur. Postoperatif dönemdeki etkisiz
ağrı kontrolü, stres cevabı artırıp endokrin, solunum, kardiyovasküler, gastrointestinal, kas iskelet sistemleri bozukluklarına ve hasta psikolojisi
üzerinde önemli değişikliklere yol açmaktadır. Ağrı kontrolünde yüksek doz ilaç kullanımından kaynaklanan yan etkiler de komplikasyonları
artırmaktadır. Multimodal analjezi uygulamaları farklı etki mekanizmalarına sahip analjeziklerin birlikte kullanımıyla additif veya sinerjistik etki
oluşturarak, tek ajanın yüksek doz kullanımıyla oluşabilecek yan etkileri azaltmayı amaçlar. Bu bağlamda komplikasyonlarını en aza indirmeyi,
ağrıyı ortadan kaldırmayı, iyileşmeyi hızlandırmayı, erken ambulasyona teşvik etmeyi ve böylece hastanede kalış süresini azaltmayı amaçlayan
protokoller geliştirilmiştir. Multimodal analjezi uygulamalarını içeren Cerrahi Sonrası Hızlandırılmış İyileşme protokolleri ve prosedür spesifik
protokoller bunlardan bazılarıdır. Bu derlemenin amacı mevcut kanıtlar ışığında hasta ve prosedür spesifik olarak en optimal perioperatif ağrı
yönetimi stratejilerini vurgulamaktır.

Keywords

Postoperatif ağrı , multimodal analjezi , ERAS , prosedür spesifik postoperatif ağrı yönetim

Ethical Statement

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Supporting Institution

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Project Number

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Thanks

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