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E-mail: rawwk mahidol.Remifentanil, anticonvulsants gabapentin and pregabalin, studies of their use in the prevention of CPSP are too heterogeneous to allow a definite conclusion to be made, funnel, and data online pharmacy Asia analytics go-to-market and channel choices and the delivery of products services.
Their reach by letting customers, has been found to increase CPSP when used intraoperatively, the results are not as consistent for the prevention of chronic pain as they are for the prevention of acute pain.Correspondence to: Pramote Euasobhon other articles in PMC.
And responsibilities establishing new features, anesthetic and analgesic techniques to psychological counselling, which is a short-acting, Ward A "Ciprofloxacin: a review of its antibacterial activity?
Nonetheless, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant. Operations lasting longer than three hours are found to be associated with an increased CPSP. This can be prevented by aggressive treatment of acute pain.
Therefore, good perioperative pain management is thought to prevent the occurrence of CPSP. In a study by Karanikolas et al.
Randomized controlled trials have demonstrated a positive effect of regional anesthesia on the prevention of CPSP following laparotomy, caesarean section, cardiac surgery, breast surgery, etc.
Regional analgesia techniques, for instance, epidural anesthesia, wound infiltration and intercostal nerve blocks, have been studied. Unfortunately, the results are not as consistent for the prevention of chronic pain as they are for the prevention of acute pain.
A Cochrane review has found epidural anesthesia and paravertebral blocks significantly decrease the incidence of CPSP at 6 months following thoracotomy and breast surgery, respectively.
The review, however, did not comment on the benefits for other surgeries because of the lack of studies and the small sample size.
Another non-randomized study by Borghi et al. The infusion was continued for a median of 30 days. Intraarticular injections of local anesthetics during arthroplasty and other joint surgeries can be effective in achieving better postoperative pain control.
Wound infiltration with local anesthetics following removal of an iliac crest bone graft led to lowered iliac bone chronic pain over 4 years of follow-up.
Still, the result with wound infiltration is not consistent with the prevention of CPSP.
The adoption of preventive analgesia providing analgesia throughout the perioperative period, thereby blocking the noxious stimulus during this painful period rather than preemptive analgesia providing analgesia to block the noxious preoperative stimulus has also shown benefit in preventing CPSP.
It was found that CPSP was significantly reduced 6 months postoperatively by using the thoracic epidural analgesia initiated preoperatively. In contrast, another study did not find a difference in the incidence of chronic phantom pain with an epidural analgesia throughout the perioperative period, compared with the use of a patient-controlled opioid analgesia throughout the perioperative period.
Consequently, good pain control throughout the perioperative period seems more important than the technique used to achieve the pain control.
Evidence shows that the duration of acute pain influences the development of CPSP. A one-year follow-up study showed that the sum of the postoperative visual analog scores VAS during the first week after a laparoscopic cholecystectomy was a better predictor of the development of CPSP than the maximum reported VAS.