الفهرس 
Mechanism of Pain and Analgesia
Complications of postoperative painOnly 14 pages are availabe for public view
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Abstract
Management of postoperative pain relieves suffering
and leads to earlier mobilization, shortened hospital stay, reduced
hospital costs, and increased patient satisfaction. Pain control
regimens should not be standardized; rather, they are tailored to
the needs of the individual patient, taking into account medical,
psychological, and physical condition; age; level of fear or
anxiety; surgical procedure; personal preference; and response to
agents given.
Nociception is the physiologic process of activation of
neural pathways by stimuli that are potentially or currently
damaging to tissue. Pain in contrast to nociception, is a conscious
experience.
Local anesthetics are drugs used to prevent or relieve pain
in specific regions of the body. Currently used local anesthetics
bind to voltage-gated Na+channels in peripheral nerves, block
sodium movement through sodium channel, and thus block nerve
conduction.
Local anaesthetics may be toxic if sufficient amounts are
absorbed into the systemic circulation. Of these bupivacaine Intraoperative administration of epidural or intrathecal
opioids for example reduces the need for systemic opioids
postoperatively. For major abdominal surgeries with extensive
incisions, epidural infusions with local anesthetic provide superior
pain relief as compared with conventional parenteral narcotics.
It is increasingly being recognized that solution to
the problem of postoperative pain management lies not so much in
the development of new techniques as in the development of an
organization to exploit existing expertise on the use of neuraxial
opioids and non-opioid
Extensive international experience points convincingly that
patients receiving neuraxial opioids or non-opioids for
postoperative analgesia can be safely nursed in regular wards,
provided trained personnel and appropriate guidelines are
available and followed. The identification of appropriate
”augmentation strategies” using neuraxial opioids or non-opioids
for labour pain, intraoperative pain, postoperative pain, chronic
pain and cancer pain, and need for future ”safety studies” and
”outcome studies” with these augmentation techniques shall go a
long way in optimizing patient safety and comfort.