Abstract
Pain following intracranial surgery has historically been undertreated because of the concern that opioids, the analgesics most commonly used to treat moderate-to-severe pain, will interfere with the neurologic examination and adversely affect postoperative outcome. Over the past decade, accumulating evidence, primarily in adult patients, has revealed that moderate-to-severe pain is common in neurosurgical patients following surgery. Using the neurophysiology of pain as a blueprint, we have highlighted some of the drugs and drug families used in multimodal pain management. This analgesic method minimizes opioid-induced adverse side effects by maximizing pain control with smaller doses of opioids supplemented with neural blockade and nonopioid analgesics, such nonsteroidal antiinflammatory drugs, local anesthetics, corticosteroids, N-methyl-D-aspartate (NMDA) antagonists, α2- adrenergic agonists, and/or anticonvulsants (gabapentin and pregabalin).
Original language | English (US) |
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Pages (from-to) | 724-733 |
Number of pages | 10 |
Journal | Paediatric anaesthesia |
Volume | 24 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2014 |
Keywords
- age
- analgesics
- nervous system physiology
- neurosurgery
- pain management
- patient-controlled analgesia
- pediatric
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Anesthesiology and Pain Medicine