The status of pre-emptive analgesia

Abstract

A few clinical studies have demonstrated statistically significant effects of pre-emptive analgesia on acute postoperative pain, but no major effects on postoperative analgesia or analgesic requirements have been documented in any study. The only way to prevent central sensitization might be to completely block any pain originating from the surgical wound from the time of incision until final wound healing. Another approach may be administration of N-methyl-D-aspartate receptor antagonists, and future clinical studies will reveal whether combinations of N-methyl-D-aspartate receptor antagonists and 'classic' analgesics may provide a new tool in the management of acute postoperative pain. Two encouraging studies have demonstrated reduced phantom limb pain with perioperative epidural analgesia compared with on-demand opioid analgesia. These studies obviously need to confirmed by others.