Esther Pogatzki-Zahn1, Chandani Chandrasena, Stephan A Schug. 1. aClinic of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Muenster, Germany bDepartment of Anaesthesia and Pain Medicine, Royal Perth Hospital cSchool of Medicine and Pharmacology, University of Western Australia, Perth, Australia.
Abstract
PURPOSE OF REVIEW: Postoperative pain remains poorly treated in many patients. One reason is the inadequate use of nonopioid analgesics. This review examines the most recent findings on nonopioid analgesics and how these translate into clinical practice. RECENT FINDINGS: Commonly used nonopioid analgesics are paracetamol, NSAIDs and metamizol (dipyrone). For paracetamol, the efficacy is obviously inferior to NSAIDs and the risk of adverse events might have been underestimated in the past. For NSAIDs, there are increasing data supporting similar efficacy of nonselective and cyclooxygenase-2 selective NSAIDs, although the adverse effects of the latter might make them the preferred option for short-term use in the perioperative setting. Metamizol (dipyrone) is a very effective nonopioid analgesic not worldwide available; the discussion on the relevance of the very rare adverse event agranulocytosis continues. SUMMARY: Nonopioid analgesics are important components of multimodal postoperative analgesia. The selection of the most appropriate compound for an individual patient can be based more and more on ever increasing data on these important analgesics.
PURPOSE OF REVIEW: Postoperative pain remains poorly treated in many patients. One reason is the inadequate use of nonopioid analgesics. This review examines the most recent findings on nonopioid analgesics and how these translate into clinical practice. RECENT FINDINGS: Commonly used nonopioid analgesics are paracetamol, NSAIDs and metamizol (dipyrone). For paracetamol, the efficacy is obviously inferior to NSAIDs and the risk of adverse events might have been underestimated in the past. For NSAIDs, there are increasing data supporting similar efficacy of nonselective and cyclooxygenase-2 selective NSAIDs, although the adverse effects of the latter might make them the preferred option for short-term use in the perioperative setting. Metamizol (dipyrone) is a very effective nonopioid analgesic not worldwide available; the discussion on the relevance of the very rare adverse event agranulocytosis continues. SUMMARY: Nonopioid analgesics are important components of multimodal postoperative analgesia. The selection of the most appropriate compound for an individual patient can be based more and more on ever increasing data on these important analgesics.
Authors: Erik M Helander; Bethany L Menard; Chris M Harmon; Ben K Homra; Alexander V Allain; Gregory J Bordelon; Melville Q Wyche; Ira W Padnos; Anna Lavrova; Alan D Kaye Journal: Curr Pain Headache Rep Date: 2017-01
Authors: Shigeyoshi Yamanaga; Andrew Mark Posselt; Chris Earl Freise; Takaaki Kobayashi; Mehdi Tavakol; Sang-Mo Kang Journal: J Transplant Date: 2017-01-22
Authors: Ana Kowark; Rolf Rossaint; Friedrich Pühringer; András P Keszei; Harald Fritz; Gebhard Fröba; Christopher Rex; Hansjörg Haas; Volker Otto; Mark Coburn Journal: Eur J Anaesthesiol Date: 2018-08 Impact factor: 4.330
Authors: Neil Singla; Matthew Bindewald; Sonia Singla; David Leiman; Harold Minkowitz; Stewart W McCallum; Randall J Mack; Rosemary Keller; Alex Freyer; Wei Du Journal: Plast Reconstr Surg Glob Open Date: 2018-06-19