Oral multimodal preemptive analgesia improves postoperative pain control and decreases opioid utilization in spinal fusion patients

A New Neuroanesthetic Protocol of Rendering Specialized Care in Treating Degenerative Lumbar Spine Diseases in High-Risk Patients: Prospective Analysis of the Results

“…To improve the course of the perioperative period in patients with degenerative spine diseases, the following methods of anesthesia support are proposed: inhalation anesthesia [31], combined anesthesia with methadone and ketamine [32], combinations of ketamine and propofol [33], spinal anesthesia with bupivacaine [34]. A high opioid-saving effect and a small number of anesthesia-related complications are observed in the combination of minimally invasive surgical techniques with multimodal analgesia [35], intravenous sedation [36], or local anesthesia [37]. According to the systematic analysis of 31 randomized clinical studies, the reliable efficacy of the perioperative analgesia is achieved by using nonsteroidal anti-inflammatory drugs, COX-2 inhibitors, ketamine, and epidural analgesia [38], whereas an application of gabapentin and methadone is associated with a high risk of adverse drug effects and the efficacy of using local anesthetics, dexmedetomidine, glucocorticoids has not been validated [38].…”

Evaluation of the safety and effects of pregabalin premedication on sleep quality, haemodynamic changes and pain in elderly patients with comorbidities undergoing spinal stenosis

“…Woolf laid groundwork for the emergence of the concept of 'preemptive analgesia' by using antinociceptive treatment that blocks the conduction of afferent signals. This technique is used to identify pain mechanisms to reduce pain due to incision and inflammation damage [5,6].…”