Recent Advances in Acute Pain Management: Understanding the Mechanisms of Acute Pain, the Prescription of Opioids, and the Role of Multimodal Pain Therapy

Overview

Journal F1000Res

Specialties Biomedical Engineering
Science

Date 2017 Dec 12

PMID 29225793

Citations 25

Authors

Richa Wardhan

Jacques Chelly

Affiliations

Soon will be listed here.

Abstract

In this review, we discuss advances in acute pain management, including the recent report of the joint American Pain Society and American Academy of Pain Medicine task force on the classification of acute pain, the role of psychosocial factors, multimodal pain management, new non-opioid therapy, and the effect of the "opioid epidemic". In this regard, we propose that a fundamental principle in acute pain management is identifying patients who are most at risk and providing an "opioid free anesthesia and postoperative analgesia". This can be achieved by using a multimodal approach that includes regional anesthesia and minimizing the dose and the duration of opioid prescription. This allows prescribing medications that work through different mechanisms. We shall also look at the recent pharmacologic and treatment advances made in acute pain and regional anesthesia.

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References

Sinatra R, Jahr J, Reynolds L, Viscusi E, Groudine S, Payen-Champenois C . Efficacy and safety of single and repeated administration of 1 gram intravenous acetaminophen injection (paracetamol) for pain management after major orthopedic surgery. Anesthesiology. 2005; 102(4):822-31. DOI: 10.1097/00000542-200504000-00019. View

Nackley A, Tan K, Fecho K, Flood P, Diatchenko L, Maixner W . Catechol-O-methyltransferase inhibition increases pain sensitivity through activation of both beta2- and beta3-adrenergic receptors. Pain. 2006; 128(3):199-208. PMC: 1905861. DOI: 10.1016/j.pain.2006.09.022. View

Campa D, Gioia A, Tomei A, Poli P, Barale R . Association of ABCB1/MDR1 and OPRM1 gene polymorphisms with morphine pain relief. Clin Pharmacol Ther. 2007; 83(4):559-66. DOI: 10.1038/sj.clpt.6100385. View

Macario A, Royal M . A literature review of randomized clinical trials of intravenous acetaminophen (paracetamol) for acute postoperative pain. Pain Pract. 2010; 11(3):290-6. DOI: 10.1111/j.1533-2500.2010.00426.x. View

. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012; 116(2):248-73. DOI: 10.1097/ALN.0b013e31823c1030. View

Theunissen M, Peters M, Bruce J, Gramke H, Marcus M . Preoperative anxiety and catastrophizing: a systematic review and meta-analysis of the association with chronic postsurgical pain. Clin J Pain. 2012; 28(9):819-41. DOI: 10.1097/AJP.0b013e31824549d6. View

Polomano R, Buckenmaier 3rd C, Kwon K, Hanlon A, Rupprecht C, Goldberg C . Effects of low-dose IV ketamine on peripheral and central pain from major limb injuries sustained in combat. Pain Med. 2013; 14(7):1088-100. DOI: 10.1111/pme.12094. View

Nosyk B, Anglin M, Brissette S, Kerr T, Marsh D, Schackman B . A call for evidence-based medical treatment of opioid dependence in the United States and Canada. Health Aff (Millwood). 2013; 32(8):1462-9. PMC: 4570728. DOI: 10.1377/hlthaff.2012.0846. View

Yuhara H, Corley D, Nakahara F, Nakajima T, Koike J, Igarashi M . Aspirin and non-aspirin NSAIDs increase risk of colonic diverticular bleeding: a systematic review and meta-analysis. J Gastroenterol. 2013; 49(6):992-1000. DOI: 10.1007/s00535-013-0905-z. View

10.

Gibbison B, Bailey C, Klein A . Tramadol - the Marmite(™) drug. Anaesthesia. 2014; 70(2):125-30. DOI: 10.1111/anae.12972. View

11.

Jouguelet-Lacoste J, La Colla L, Schilling D, Chelly J . The use of intravenous infusion or single dose of low-dose ketamine for postoperative analgesia: a review of the current literature. Pain Med. 2014; 16(2):383-403. DOI: 10.1111/pme.12619. View

12.

Mickle A, Shepherd A, Loo L, Mohapatra D . Induction of thermal and mechanical hypersensitivity by parathyroid hormone-related peptide through upregulation of TRPV1 function and trafficking. Pain. 2015; 156(9):1620-1636. PMC: 5070921. DOI: 10.1097/j.pain.0000000000000224. View

13.

Lobo K, Donado C, Cornelissen L, Kim J, Ortiz R, Peake R . A Phase 1, Dose-escalation, Double-blind, Block-randomized, Controlled Trial of Safety and Efficacy of Neosaxitoxin Alone and in Combination with 0.2% Bupivacaine, with and without Epinephrine, for Cutaneous Anesthesia. Anesthesiology. 2015; 123(4):873-85. DOI: 10.1097/ALN.0000000000000831. View

14.

Radvansky B, Shah K, Parikh A, Sifonios A, Le V, Eloy J . Role of ketamine in acute postoperative pain management: a narrative review. Biomed Res Int. 2015; 2015:749837. PMC: 4606413. DOI: 10.1155/2015/749837. View

15.

Scott E, Kroenke K, Wu J, Yu Z . Beneficial Effects of Improvement in Depression, Pain Catastrophizing, and Anxiety on Pain Outcomes: A 12-Month Longitudinal Analysis. J Pain. 2015; 17(2):215-22. DOI: 10.1016/j.jpain.2015.10.011. View

16.

Wang L, Johnston B, Kaushal A, Cheng D, Zhu F, Martin J . Ketamine added to morphine or hydromorphone patient-controlled analgesia for acute postoperative pain in adults: a systematic review and meta-analysis of randomized trials. Can J Anaesth. 2015; 63(3):311-25. DOI: 10.1007/s12630-015-0551-4. View

17.

Chou R, Gordon D, de Leon-Casasola O, Rosenberg J, Bickler S, Brennan T . Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive.... J Pain. 2016; 17(2):131-57. DOI: 10.1016/j.jpain.2015.12.008. View

18.

Choi S, Lim J, Yoo S, Kim H, Hwang S . Emerging Role of Spinal Cord TRPV1 in Pain Exacerbation. Neural Plast. 2016; 2016:5954890. PMC: 4738952. DOI: 10.1155/2016/5954890. View

19.

Horosz B, Nawrocka K, Malec-Milewska M . Anaesthetic perioperative management according to the ERAS protocol. Anaesthesiol Intensive Ther. 2016; 48(1):49-54. DOI: 10.5603/AIT.2016.0006. View

20.

Cherkin D, Sherman K, Balderson B, Cook A, Anderson M, Hawkes R . Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA. 2016; 315(12):1240-9. PMC: 4914381. DOI: 10.1001/jama.2016.2323. View