The Effects of Pain and Analgesic Medications on Blood Pressure

Rivasi, Giulia; Menale, Silvia; Turrin, Giada; Coscarelli, Antonio; Giordano, A.; Ungar, Andrea

doi:10.1007/s11906-022-01205-5

Cited by 19 publications

(14 citation statements)

References 78 publications

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“…As can be seen from Table 2 , non-significant results of hemodynamic parameters were in disagreement with results that pain scores at 2 h showed significant differences. One reasonable explanation is that although hemodynamic parameters could reflect the change of pain, they are also considered susceptible to other factors such as analgesic medications (including paracetamol, opioids, and non-steroidal anti-inflammatory drugs) [ 37 , 49 , 50 , 51 ]. Hence, analgesic medications such as opioids inducing hypotension may mask hemodynamic parameter changes induced by pain.…”

Section: Discussionmentioning

confidence: 99%

“…The secondary outcomes included the following: (1) resting pain scores postoperatively at other time points (cm); (2) dynamic pain scores postoperatively at other time points (cm); (3) cumulative morphine equivalent consumption within 12, 24, and 48 h postoperatively (mg); (4) time to first analgesic request (hours); and (5) hemodynamic parameters included heart rate (beat/min), systolic blood pressure (SBP) (mm/Hg) as well as diastolic blood pressure (DBP) (mm/Hg) at 2, 6, 12, and 24 h. We chose hemodynamic parameters as the secondary outcomes for 2 reasons. First, the release of cortisol and catecholamines mediated by pain results in heart rate and blood pressure increase, hence hemodynamic parameters were chosen as indirect physiological changes of pain [ 37 ]. Second, the time points selected were based on its frequent reporting in included studies.…”

Section: Methodsmentioning

confidence: 99%

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A Meta-Analysis Showing the Quantitative Evidence Base of Preemptive Pregabalin for Postoperative Pain from Cancer-Related Surgery

Wang

Dong

et al. 2023

Medicina

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Background and Objectives: As an adjunct to postoperative multimodal analgesic regimens, pregabalin has been reported in reducing postoperative acute pain and opioid consumption. However, there is only a small amount of evidence for preemptive pregabalin in patients undergoing cancer-related surgery. This systematic review was conducted to integrate high-quality evidence to evaluate the preemptive analgesic effects of pregabalin in cancer-related surgery. Materials and Methods: Seven electronic databases were searched in a combination of subject terms and free words. Efficacy and safety of preemptive pregabalin on postoperative pain for cancer-related surgery were evaluated by assessing resting and dynamic pain scores postoperatively, cumulative morphine equivalent consumption, time to first analgesic request, hemodynamic parameters, and the safety indicators. Results: Thirteen trials were incorporated for quantitative synthesis. The pooled results showed administration of pregabalin preoperatively is clinically significant for improving resting (weighted mean difference (WMD), −1.53 cm; 95% CI, −2.30 to −0.77) and dynamic (WMD, −1.16 cm; 95% CI, −2.22 to −0.11) pain severity scores at 2 h postoperatively and prolonging time to first analgesic request (WMD, 2.28 h; 95% CI, 0.79 to 3.77) in cancer-related surgery. Preemptive pregabalin was also statistically effective in some other pain indicators but would increase the risk of pregabalin-related side effects after surgery. Conclusions: Our findings do not support the administration of pregabalin in doses larger than 300 mg when put in cancer-related surgery. Taken together, more high-quality research particularly focused on the optimal dosages and timing of pregabalin in cancer-related surgery is needed in the future to establish stronger evidence for therapeutic effects.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A Meta-Analysis Showing the Quantitative Evidence Base of Preemptive Pregabalin for Postoperative Pain from Cancer-Related Surgery

Wang

Dong

et al. 2023

Medicina

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“…Even if acetaminophen represents an attractive drug in the management of fever and flulike symptoms in children, the elderly, and pregnant women, due to its safety profile, recent data suggest that it has no anti‐inflammatory activity and has the same toxicity and drug interaction risk of the other NSAIDs 58–60 . In contrast, ibuprofen is a COX‐1/2 balanced inhibitor, and several studies documented that its use is related to low gastrointestinal, cardiovascular, renal, and skin risk compared to the other NSAIDs 61–67 …”

Section: Methodsmentioning

confidence: 99%

“…[58][59][60] In contrast, ibuprofen is a COX-1/2 balanced inhibitor, and several studies documented that its use is related to low gastrointestinal, cardiovascular, renal, and skin risk compared to the other NSAIDs. [61][62][63][64][65][66][67] Some authors described the development of respiratory failure 68 and empyema 69 in patients with acute viral infection exposed to NSAIDs. However, the development of respiratory adverse effects probably could be related to the effects of NSAIDs that prevent the timely recognition of respiratory diseases, leading to a delay in the diagnosis, promoting a more invasive disease.…”

Section: Clinical Studiesmentioning

confidence: 99%

Ibuprofen in the Management of Viral Infections: The Lesson of COVID‐19 for Its Use in a Clinical Setting

Marcianò¹,

Gallelli²,

Rania³

et al. 2023

The Journal of Clinical Pharma

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Nonsteroidal anti‐inflammatory drugs (NSAIDs) are commonly used for the management of fever, pain, and inflammation. However, they have always been considered to have a double‐faced role, according to their capacity to manage inflammation but also their possible reduction of immune system response and diagnosis delay. This last point could favor a dramatic increase of viral infection diffusion, possibly leading to a more severe outcome. The advent of severe acute respiratory syndrome coronavirus 2 excluded the use of NSAIDs, particularly ibuprofen, and then indicated this drug as the better NSAID to manage infected outpatients and prevent complications. Several authors described the role of NSAIDs and ibuprofen in preventing cytokine storm and modulating the immune system. However, the development of both adverse drug reactions (i.e., gastrointestinal, renal, hepatic, and cardiovascular) and drug interaction recalled the necessity of prescribing the better NSAID for each patient. In this narrative review, we describe the role of NSAIDs, particularly of ibuprofen, in the management of viral symptoms, suggesting that the NSAID may be chosen considering the characteristics of the patient, the comorbidity, and the polytherapy.

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“…Various studies have established a correlation between pain and physiological indicators, such as systolic blood pressure and heart rate. Moreover, research has highlighted the influences of physiological factors on human vocalization [ 68 , 69 , 70 , 71 , 72 , 73 , 74 ].…”

Section: Review Of the Studiesmentioning

confidence: 99%

A Review of Voice-Based Pain Detection in Adults Using Artificial Intelligence

et al. 2023

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Pain is a complex and subjective experience, and traditional methods of pain assessment can be limited by factors such as self-report bias and observer variability. Voice is frequently used to evaluate pain, occasionally in conjunction with other behaviors such as facial gestures. Compared to facial emotions, there is less available evidence linking pain with voice. This literature review synthesizes the current state of research on the use of voice recognition and voice analysis for pain detection in adults, with a specific focus on the role of artificial intelligence (AI) and machine learning (ML) techniques. We describe the previous works on pain recognition using voice and highlight the different approaches to voice as a tool for pain detection, such as a human effect or biosignal. Overall, studies have shown that AI-based voice analysis can be an effective tool for pain detection in adult patients with various types of pain, including chronic and acute pain. We highlight the high accuracy of the ML-based approaches used in studies and their limitations in terms of generalizability due to factors such as the nature of the pain and patient population characteristics. However, there are still potential challenges, such as the need for large datasets and the risk of bias in training models, which warrant further research.

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The Effects of Pain and Analgesic Medications on Blood Pressure

Cited by 19 publications

References 78 publications

A Meta-Analysis Showing the Quantitative Evidence Base of Preemptive Pregabalin for Postoperative Pain from Cancer-Related Surgery

A Meta-Analysis Showing the Quantitative Evidence Base of Preemptive Pregabalin for Postoperative Pain from Cancer-Related Surgery

Ibuprofen in the Management of Viral Infections: The Lesson of COVID‐19 for Its Use in a Clinical Setting

A Review of Voice-Based Pain Detection in Adults Using Artificial Intelligence

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