Efficacy and Safety of Nonopioid Analgesics in Perioperative Pain Control

Thomas, Donna-Ann; West, M J; Legler, Aron; Maslin, Benjamin; Kim, Richard K.; Vadivelu, Nalini

doi:10.2174/1574886311666160426130444

Cited by 6 publications

(3 citation statements)

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“…However, such outcomes can be misleading in very small, poorly controlled, or unblinded studies that do not account for placebo effects. Similarly, the voices of patient advocates should be made known, but many such groups are financially supported by drug manufacturers to help advance their goals . Even in the absence of such support, popular opinion can be shaped by uncritical enthusiasm by patients and their families, or by unbalanced reports from the manufacturer.…”

mentioning

confidence: 99%

Approving a Problematic Muscular Dystrophy Drug

Kesselheim

Avorn

2016

JAMA

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confidence: 99%

Approving a Problematic Muscular Dystrophy Drug

Kesselheim

Avorn

2016

JAMA

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“…In this regard, evidence for various analgesic candidates applicable to multimodal analgesia is obviously required. Furthermore, the identification of analgesic candidates based on food-based bioactive species is expected to broaden the scope and efficacy of multimodal analgesia strategies [ 24 ]. Fruits, vegetables, and other plant foods contain phytochemicals, which are nutrient-rich bioactive plant chemicals that may confer beneficial effects on human health.…”

Section: Discussionmentioning

confidence: 99%

Effect of Immature Rubus occidentalis on Postoperative Pain in a Rat Model

et al. 2023

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Background and Objectives: This study aimed to identify the analgesic properties of immature Rubus occidentalis extract (iROE) using a postoperative-pain rat model. We also aimed to compare the analgesic effects of iROE to those of mature R. occidentalis extract (mROE) and examine the proinflammatory cytokine response and associated underlying mechanisms. Materials and Methods: In adult male Sprague Dawley rats, acute postoperative pain was induced through plantar hind-paw incisions. After the plantar incisions were made, the rats were intraperitoneally administered with normal saline or various doses of iROE and mROE to investigate and compare the analgesic effects of iROE and mROE. The mechanisms underlying iROE-induced analgesia were investigated via post-incisional administration of yohimbine, dexmedetomidine, prazosin, naloxone, atropine, or mecamylamine, followed by iROE. Mechanical withdrawal threshold (MWT) evaluations with von Frey filaments were carried out at different time points. Serum levels of tumor necrosis factor α, interleukin (IL)–1β, and IL-6 were measured to assess inflammatory responses. Multivariate analysis of variance (MANOVA) and linear mixed-effects model (LMEM) analysis were used to analyze the analgesic effect data. Results: The MWTs demonstrated significant increases in iROE in a dose-dependent manner up to 2 h after the plantar incisions were made. An LMEM analysis demonstrated that iROE yielded a significantly greater analgesic effect than mROE, but there was no significant difference between the two according to MANOVA. Dexmedetomidine enhanced the MWT-confirmed iROE response, while yohimbine and naloxone diminished it. Administration of iROE significantly attenuated the post-incisional increases in serum IL-1β and IL-6 levels. Conclusions: The iROE demonstrated analgesic and anti-inflammatory effects in a rat model of incisional pain, which were more pronounced than those associated with mROE. The analgesic activity of iROE may be associated with α2-adrenergic and opioid receptors.

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“…More effective and appropriate control of postsurgical pain is necessary for shortening hospital stays and improving life quality of patients with local surgeries 6–10. Standard methods of postsurgical systematic analgesia include administration of parenteral and oral non-steroidal anti-inflammatory drugs and opioids,11–13 but these can cause adverse effects such as vomiting, central nervous system depression, respiratory depression and constipation 14 15. Local analgesics have been employed for the postoperative pain control to avoid these side effects from systemic analgesia 16–19…”

Section: Introductionmentioning

confidence: 99%

HYR-PB21-LA, a potential extended-release bupivacaine formulation, produces long-lasting local anesthesia in rats and guinea pigs

Peng

Liu

et al. 2020

Reg Anesth Pain Med

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BackgroundEffective postoperative pain management plays a key role in enhancing recovery of patients after surgery. Bupivacaine hydrochloride is one of the most commonly local anesthetics used for the postoperative pain control. However, the relatively short anesthesia duration of bupivacaine preparations limited their clinical application.MethodsBoth guinea pig pin-prick study and rat tail-flick test were performed to evaluate the local anesthesia efficacy of HYR-PB21-LA, a new microparticle suspension injection of bupivacaine pamoate.ResultsIn the pin-prick test, the complete cutaneous trunci muscle reflex inhibitions were observed at 30 min in all treatment groups containing bupivacaine. In comparison with 6.7 mg/mL HYR-PB21-LA, both 10 and 20 mg/mL HYR-PB21-LA groups had significantly higher area under effect time curve (AUEC) values (p<0.001 and p<0.0001) and slower offset time (p<0.0001). Significantly higher AUEC (p<0.0001) and slower offset time (p<0.0001) were also found in 10 mg/mL HYR-PB21-LA treatment group compared with bupivacaine liposome injectable suspension (liposomal bupivacaine). In the rat tail-flick test, significantly increased local anesthesia effect was lasted for 5 hours after 2.5 mg/mL HYR-PB21-LA administration, which was fivefold longer than bupivacaine hydrochloride. The longer lasted efficacy of significantly increased local anesthesia was also observed in 5 mg/mLHYR-PB21-LA than those in liposomal bupivacaine (8 hour vs 1 hour).ConclusionsThe results demonstrated that the HYR-PB21-LA produced longer local anesthesia effect than current clinical preparations of bupivacaine in two animal models. These findings raise the potential clinical value of HYR-PB21-LA as a long-lasting local anesthesia for controlling postsurgical pain in humans.

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Efficacy and Safety of Nonopioid Analgesics in Perioperative Pain Control

Cited by 6 publications

References 0 publications

Approving a Problematic Muscular Dystrophy Drug

Approving a Problematic Muscular Dystrophy Drug

Effect of Immature Rubus occidentalis on Postoperative Pain in a Rat Model

HYR-PB21-LA, a potential extended-release bupivacaine formulation, produces long-lasting local anesthesia in rats and guinea pigs

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