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- W2101335280 endingPage "1161" @default.
- W2101335280 startingPage "1141" @default.
- W2101335280 abstract "The use of local anesthetics to reduce acute postoperative pain has a long history, but recent reports have not been systematically reviewed. In addition, the need to include only those clinical studies that meet minimum standards for randomization and blinding must be adhered to. In this review, we have applied stringent clinical study design standards to identify publications on the use of perioperative local anesthetics. We first examined several types of peripheral nerve blocks, covering a variety of surgical procedures, and second, we examined the effects of intentionally administered IV local anesthetic (lidocaine) for suppression of postoperative pain. Thirdly, we have examined publications in which vascular concentrations of local anesthetics were measured at different times after peripheral nerve block procedures, noting the incidence when those levels reached ones achieved during intentional IV administration. Importantly, the very large number of studies using neuraxial blockade techniques (epidural, spinal) has not been included in this review but will be dealt with separately in a later review. The overall results showed a strongly positive effect of local anesthetics, by either route, for suppressing postoperative pain scores and analgesic (opiate) consumption. In only a few situations were the effects equivocal. Enhanced effectiveness with the addition of adjuvants was not uniformly apparent. The differential benefits between drug delivery before, during, or immediately after a surgical procedure are not obvious, and a general conclusion is that the significant antihyperalgesic effects occur when the local anesthetic is present during the acute postoperative period, and its presence during surgery is not essential for this action." @default.
- W2101335280 created "2016-06-24" @default.
- W2101335280 creator A5000467325 @default.
- W2101335280 creator A5013429792 @default.
- W2101335280 creator A5034538984 @default.
- W2101335280 creator A5039485353 @default.
- W2101335280 creator A5070484884 @default.
- W2101335280 date "2013-05-01" @default.
- W2101335280 modified "2023-10-18" @default.
- W2101335280 title "Preventive Analgesia by Local Anesthetics" @default.
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