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Pain facts 5 . Dr. S. Parthasarathy MD., DA., DNB, MD ( Acu ), Dip. Diab . DCA, Dip. Software statistics PhD ( physio ) Mahatma Gandhi medical college and research institute , puducherry – India . Preemptive analgesia .
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Pain facts 5 Dr. S. Parthasarathy MD., DA., DNB, MD (Acu), Dip. Diab. DCA, Dip. Software statistics PhD (physio) Mahatma Gandhi medical college and research institute , puducherry – India
Preemptive analgesia • analgesia is achieved by use of pre-emptive analgesic which is initiated before surgery and continued throughout the perioperative period.
Definition • Initiating an analgesic regimen before the onset of the noxious stimulus to prevent central as well as peripheral sensitization and limit the subsequent pain experience is called pre- emptive analgesic
Example • Herniotomy • Method 1 – presurgical infiltration and GA • Method 2 – GA and postoperative infiltration
Three facts • Start before surgery • Prevents sensitization because of incision • Prevents sensitization because of post operative inflammation.
Methods and use • Definition • Continued use • Study parameters
Kundra et al • Laminectomy, • Epidural morphine before and after surgery • Better postop analgesia
Kundra et al • Paediatric hernias • Preemptive caudal bupivacaine And GA • Postop caudal bupivacaine And GA • preemptive better
Chronic pain - preemptive ok- yet • Phantom pain • Chronic incision pain • Only few studies
JOACP 2009: 25(2) 214-216 • ACUPUNCTURE – A PREEMPTIVE ANALGESIC TECHNIQUE • Dr.S.Parthasarathy • Dr.M.Ravishankar