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Current Opinion in Anaesthesiology Dec 2018The increasing number of procedures done in the ambulatory surgical setting necessitates the need for analgesic modalities that enable the management of postsurgical... (Review)
Review
PURPOSE OF REVIEW
The increasing number of procedures done in the ambulatory surgical setting necessitates the need for analgesic modalities that enable the management of postsurgical pain with fast onset, predictable duration of action, and minimal need for management of undesirable side-effects.
RECENT FINDINGS
The novel strategies for administration of local anesthetics in the ambulatory setting include prolonging their analgesic action at the site of surgical trauma while reducing systemic effects that result from their metabolism. Development of opioids aims to address receptor sites that provide for modulation of pain perception while reducing systemic, central effects of μ-receptor agonism. Other, more titratable agents with analgesic properties are also addressed.
SUMMARY
Local anesthetics, opioids, and NSAIDS are the mainstay of multimodal analgesic management, and as such, improving their efficacy in the ambulatory surgical setting remains the primary focus. However, as knowledge of the modulating pathways involved in transduction of pain increases, newer agents that utilize this knowledge are also becoming more widely available.
Topics: Ambulatory Surgical Procedures; Analgesics; Analgesics, Opioid; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Humans; Pain, Postoperative
PubMed: 30346316
DOI: 10.1097/ACO.0000000000000665 -
Drugs Jul 2017Transdermal administration of analgesic medications offers several benefits over alternative routes of administration, including a decreased systemic drug load with... (Review)
Review
Transdermal administration of analgesic medications offers several benefits over alternative routes of administration, including a decreased systemic drug load with fewer side effects, and avoidance of drug degradation by the gastrointestinal tract. Transdermal administration also offers a convenient mode of drug administration over an extended period of time, particularly desirable in pain medicine. A transdermal administration route may also offer increased safety for drugs with a narrow therapeutic window. The primary barrier to transdermal drug absorption is the skin itself. Transdermal nanotechnology offers a novel method of achieving enhanced dermal penetration with an extended delivery profile for analgesic drugs, due to their small size and relatively large surface area. Several materials have been used to enhance drug duration and transdermal penetration. The application of nanotechnology in transdermal delivery of analgesics has raised new questions regarding safety and ethical issues. The small molecular size of nanoparticles enables drug delivery to previously inaccessible body sites. To ensure safety, the interaction of nanoparticles with the human body requires further investigation on an individual drug basis, since different formulations have unique properties and side effects.
Topics: Administration, Cutaneous; Analgesics; Animals; Drug Delivery Systems; Drug Liberation; Humans; Nanoparticles; Nanotechnology; Skin Absorption
PubMed: 28470586
DOI: 10.1007/s40265-017-0744-y -
Molecules (Basel, Switzerland) Dec 2015Pain is an unpleasant sensation associated with a wide range of injuries and diseases, and affects approximately 20% of adults in the world. The discovery of new and... (Review)
Review
Pain is an unpleasant sensation associated with a wide range of injuries and diseases, and affects approximately 20% of adults in the world. The discovery of new and more effective drugs that can relieve pain is an important research goal in both the pharmaceutical industry and academia. This review describes studies involving antinociceptive activity of essential oils from 31 plant species. Botanical aspects of aromatic plants, mechanisms of action in pain models and chemical composition profiles of the essential oils are discussed. The data obtained in these studies demonstrate the analgesic potential of this group of natural products for therapeutic purposes.
Topics: Analgesics; Animals; Biological Products; Disease Models, Animal; Mice; Oils, Volatile; Pain; Rats
PubMed: 26703556
DOI: 10.3390/molecules21010020 -
Journal of Orthopaedic Surgery (Hong... 2023Pharmacotherapy is the most common strategies to reduce pain for osteoarthritis (OA) patients. To analyze the trend and pattern of prescription analgesic medication use...
OBJECTIVE
Pharmacotherapy is the most common strategies to reduce pain for osteoarthritis (OA) patients. To analyze the trend and pattern of prescription analgesic medication use in American OA patients. Besides, our study also tried to figure out the demographic characteristics of opioid use among OA population which may helpful for managing the use of opioids.
METHODS
We included 2214 OA patients from 2007 to 2018. We extracted data from National Health and Nutrition Examination Survey (NHANES) database. We compared analgesics and anti-depression medications use by category between survey participants with OA and without.
RESULTS
For OA patients, NSAIDs, acetaminophen and gabapentinoid were the mostly highly used analgesics (10.2%, 9.0% and 8.9%, respectively). However, we also found that opioids use was very common in OA patients (7.7%) and the duration of opioids use was significantly long. In addition, the opioids use did not decrease from 2007 to 2018, while gabapentinoid increased rapidly from recent decade (From 5.0% to 12.1%). The common analgesic combination used by OA population was opioids with acetaminophen and gabapentinoid with selective serotonin reuptake inhibitors (SSRIs) (2.9% and 2.7%, respectively).
CONCLUSION
The use of gabapentinoid increased rapidly from recent decade, while opioids use did not decrease. The long-term excessive use of opioids was also a serious problem for OA pain control. More improvements such as focusing more on healthcare education and paying more attention on non-pharmacotherapy and the psychological situation of patients are needed.
Topics: Humans; United States; Acetaminophen; Nutrition Surveys; Analgesics; Osteoarthritis; Analgesics, Opioid; Prescriptions
PubMed: 37724650
DOI: 10.1177/10225536231202835 -
Fundamental & Clinical Pharmacology Feb 2024Cannabis, more commonly known as marijuana or hemp, has been used for centuries to treat various conditions. Cannabis contains two main components cannabidiol (CBD) and... (Review)
Review
BACKGROUND
Cannabis, more commonly known as marijuana or hemp, has been used for centuries to treat various conditions. Cannabis contains two main components cannabidiol (CBD) and tetrahydrocannabinol (THC). CBD, unlike THC, is devoid of psychoactive effects and is well tolerated by the human body but has no direct effect on the receptors of the endocannabid system, despite the lack of action on the receptors of the endocannabid system.
OBJECTIVES AND METHODS
We have prepared a literature review based on the latest available literature regarding the analgesic effects of CBD. CBD has a wide range of effects on the human body. In this study, we will present the potential mechanisms responsible for the analgesic effect of CBD. To the best of our knowledge, this is the first review to explore the analgesic mechanisms of CBD.
RESULTS AND CONCLUSION
The analgesic effect of CBD is complex and still being researched. CBD models the perception of pain by acting on G protein-coupled receptors. Another group of receptors that CBD acts on are serotonergic receptors. The effect of CBD on an enzyme of potential importance in the production of inflammatory factors such as cyclooxygenases and lipoxygenases has also been confirmed. The presented potential mechanisms of CBD's analgesic effect are currently being extensively studied.
Topics: Humans; Cannabidiol; Cannabis; Analgesics; Pain
PubMed: 37584368
DOI: 10.1111/fcp.12947 -
Molecules (Basel, Switzerland) Dec 2020The subject of the work was the synthesis of new derivatives of1-pyrrolo[3,4-c]pyridine-1,3(2)-dione with potential analgesic and sedative activity. Eight compounds...
The subject of the work was the synthesis of new derivatives of1-pyrrolo[3,4-c]pyridine-1,3(2)-dione with potential analgesic and sedative activity. Eight compounds werereceived. The analgesic activity of the new compounds was confirmed in the "hot plate" test and in the "writhing" test. All tested imides - were more active in the "writhing" test than aspirin, and two of them, and , were similar to morphine. In addition, all of the new imides inhibited the locomotor activity in mice to a statistically significant extent, and two of them also prolonged the duration of thiopental sleep.On the basis of the results obtained for the previously synthesized imides and the results presented in this paper, an attempt was madeto determine the relationship between thechemical structure of imides and their analgesic and sedativeproperties.
Topics: Analgesics; Animals; Hypnotics and Sedatives; Locomotion; Male; Mice; Pyridines; Pyrroles; Structure-Activity Relationship
PubMed: 33322767
DOI: 10.3390/molecules25245883 -
Journal of Pain & Palliative Care... 2016Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more...
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. In reply to a question about medication overuse headache, its presentation, causes, treatment, and prevention will be discussed.
Topics: Analgesics; Headache Disorders, Secondary; Humans; Patient Education as Topic
PubMed: 26848140
DOI: 10.3109/15360288.2015.1063565 -
Minerva Anestesiologica Apr 2015Topical analgesics may play an important role in the management of chronic pain and have good tolerability. Systemic ketamine has limited usage as an anesthetic and... (Review)
Review
Topical analgesics may play an important role in the management of chronic pain and have good tolerability. Systemic ketamine has limited usage as an anesthetic and along with its potential for addiction and dependence has not gained popularity as an analgesic compound. Topical ketamine however, is devoid of serious side effects, and thus can be used in the management of various pain states such as neuropathic pain and complex regional pain syndrome. Despite using high concentrations of topical ketamine, clinically significant side effects are rare. The measured plasma levels of ketamine and norketamine in various studies were mostly below the threshold of detection. Topical ketamine has been used as compounded formulations alone in concentrations from 0.5% to 20% or in combination with other (co-)analgesics. Its efficacy may depend on the choice of vehicle, the concentration and the pain state. Suboptimal concentration of ketamine and suboptimal pharmaceutical properties of the cream base might have contributed to the negative results of some studies. In this article we will review clinical studies involving the use of topical ketamine for pain.
Topics: Administration, Topical; Analgesics; Humans; Ketamine; Neuralgia; Pain; Pain Management
PubMed: 24847738
DOI: No ID Found -
Deutsches Arzteblatt International Mar 2023Consumption of medication to alleviate pain is widespread in Germany. Around 1.9 million men and women take analgesics every day; some 1.6 million persons are addicted...
BACKGROUND
Consumption of medication to alleviate pain is widespread in Germany. Around 1.9 million men and women take analgesics every day; some 1.6 million persons are addicted to painkillers. Analgesic use is thought also to be common in sports, even in the absence of pain. The aim of this study was to assess the extent of painkiller use among athletes.
METHODS
In line with the PRISMA criteria and the modified PICO(S) criteria, a systematic literature review was registered (Openscienceframework, https://doi. org/10.17605/OSF.IO/VQ94D) and carried out in PubMed and SURF. The publications identified (25 survey studies, 12 analyses of doping control forms, 18 reviews) were evaluated in standardized manner using the Newcastle Ottawa Scale (NOS) and AMSTAR (A MeaSurement Tool to Assess systematic Reviews).
RESULTS
Analgesic use is widespread in elite sports. The prevalence varies between 2.8% (professional tennis) and 54.2% (professional soccer). Pain medication is also taken prophylactically in the absence of symptoms in some non-elite competitive sports. In the heterogeneous field of amateur sports the data are sparse and there is no reliable evidence of wide-reaching consumption of painkillers. Among endurance athletes, 2.1% of over 50 000 persons stated that they used analgesics at least once each month in connection with sports.
CONCLUSION
Analgesic use has become a problem in many areas of professional/ competitive sports, while the consumption of pain medication apparently remains rare in amateur sports. In view of the increasing harmful use of or even addiction to painkillers in society as a whole, there is a need for better education and, above all, restrictions on advertising.
Topics: Male; Humans; Female; Sports; Athletes; Soccer; Analgesics; Pain
PubMed: 36655316
DOI: 10.3238/arztebl.m2023.0003 -
Scandinavian Journal of Trauma,... Dec 2021Clinically meaningful pain reduction with respect to severity and the adverse events of drugs used in prehospital pain management for children are areas that have not... (Review)
Review
BACKGROUND
Clinically meaningful pain reduction with respect to severity and the adverse events of drugs used in prehospital pain management for children are areas that have not received sufficient attention. The present systematic review therefore aims to perform a comprehensive search of databases to examine the preferable drugs for prehospital pain relief in paediatric patients with acute pain, irrespective of aetiology.
METHODS
The systematic review includes studies from 2000 and up to 2020 that focus on children's prehospital pain management. The study protocol is registered in PROSPERO with registration no. CRD42019126699. Pharmacological pain management using any type of analgesic drug and in all routes of administration was included. The main outcomes were (1) measurable pain reduction (effectiveness) and (2) no occurrence of any serious adverse events. Searches were conducted in PubMed, Medline, Embase, CINAHL, Epistemonikos and Cochrane library. Finally, the risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist and a textual narrative analysis was performed due to the heterogeneity of the results.
RESULTS
The present systematic review on the effectiveness and safety of analgesic drugs in prehospital pain relief in children identified a total of eight articles. Most of the articles reviewed identified analgesic drugs such as fentanyl (intranasal/IV), morphine (IV), methoxyflurane (inhalational) and ketamine (IV/IM). The effects of fentanyl, morphine and methoxyflurane were examined and all of the included analgesic drugs were evaluated as effective. Adverse events of fentanyl, methoxyflurane and ketamine were also reported, although none of these were considered serious.
CONCLUSION
The systematic review revealed that fentanyl, morphine, methoxyflurane and combination drugs are effective analgesic drugs for children in prehospital settings. No serious adverse events were reported following the administration of fentanyl, methoxyflurane and ketamine. Intranasal fentanyl and inhalational methoxyflurane seem to be the preferred drugs for children in pre-hospital settings due to their ease of administration, similar effect and safety profile when compared to other analgesic drugs. However, the level of evidence (LOE) in the included studies was only three or four, and further studies are therefore necessary.
Topics: Acute Pain; Analgesics; Analgesics, Opioid; Child; Emergency Medical Services; Fentanyl; Humans
PubMed: 34895311
DOI: 10.1186/s13049-021-00974-3