The role of coanalgesics in pain treatment
DOI:
https://doi.org/10.12775/JEHS.2022.12.09.034Keywords
pain treatment, coanalgesics, neuropathic pain, postoperative painAbstract
Introduction
Pain management plays an important role in many fields of medicine. The basis of treatment is pharmacotherapy with typical analgesics such as NSAIDs, paracetamol and opioids, nonetheless due to their inadequacy and numerous side effects, drugs from other groups that act as coanalgesics are increasingly being used.
State of knowledge
The analysis of the effectiveness and use of individual pharmaceuticals for the treatment of pain is possible based on knowledge of basic aspects of the formation and reception of pain stimuli. In the whole process of transmission of nociceptive stimuli, receptors, which are the point of action of most of the drugs discussed in this article, play a special role.
Conclusions
A number of studies have proven that coanalgesics treatment in patients suffering from postoperative pain make it possible to reduce the doses of opioids used, which is clearly associated with a reduction in the incidence of nausea, vomiting, intestinal peristalsis disorders, as well as infections in the postoperative period, and reduces the risk of complications and allows for a shorter period of hospitalization. Coanalgesics also have applications in the treatment of chronic and neuropathic pain, where typical analgesics often fail to produce satisfactory results.
References
Misiołek H, Zajączkowska R, Daszkiewicz A, et al. Postoperative pain management — 2018 consensus statement of the Section of Regional Anaesthesia and Pain Therapy of the Polish Society of Anaesthesiology and Intensive Therapy, the Polish Society of Regional Anaesthesia and Pain Therapy, the Polish Association for the Study of Pain and the National Consultant in Anaesthesiology and Intensive Therapy. Anaesthesiology Intensive Therapy. 2018;50(3).
dr. n. med. Anna Przeklasa-Muszyńska Koanalgetyki w leczeniu bólu przewlekłego 18.09.2015
Jan Dobrogowski Niefarmakologiczne metody leczenia bólu
Wordliczek J., Dobrogowski J. Leczenie bólu. PZWL, Warszawa 2007: 11–27.;
Jan Dobrogowski, Renata Zajączkowska, Julian Dutka, Jerzy Wordliczek Patofizjologia i klasyfikacja bólu Pol. Przegl. Neurol 2011;7(1):20-30.
Zbigniew Żylicz1, 2, Małgorzata Krajnik2 1 Hospice Rozenheuvel w Rozendaal, Holandia 2 Katedra i Zakład Opieki Paliatywnej Akademii Medycznej im. Ludwika Rydygiera w Bydgoszczy Jak powstaje ból? Neurofizjologia bólu dla początkujących The mechanisms of pain. Pain neurophysiology for beginnersPolska Medycyna Paliatywna 2003, 2, 1, 49–56 Copyright © 2003 Via Medica, ISSN 1644–115X
Shang Y, Filizola M. Opioid receptors: Structural and mechanistic insights into pharmacology and signaling. Eur J Pharmacol. 2015 Sep 15;763(Pt B):206-13. doi: 10.1016/j.ejphar.2015.05.012. Epub 2015 May 14. PMID: 25981301; PMCID: PMC4584181.
Jarosław Woroń1,2, Anna Adamczyk3, Małgorzata Malec-Milewska4, Joanna Jakowicka-Wordliczek5 Stosowanie koanalgetyków u pacjentów z bólem neuropatycznym w przebiegu choroby nowotworowej
Stucky CL, Gold MS, Zhang X. Mechanisms of pain. Proc Natl Acad Sci U S A. 2001 Oct 9;98(21):11845-6. doi: 10.1073/pnas.211373398. Epub 2001 Sep 18. PMID: 11562504; PMCID: PMC59728..
Ren K, Dubner R. Descending modulation in persistent pain: an update. Pain. 2002 Nov;100(1-2):1-6. doi: 10.1016/s0304-3959(02)00368-8. PMID: 12435453.
Kranke P, Jokinen J, Pace NL, et al. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. Cochrane Database Syst Rev. 2015(7): CD009642, doi: 10.1002/14651858.CD009642. pub2, indexed in Pubmed: 26184397.
Abram SE, Yaksh TL. Systemic lidocaine blocks nerve injury-induced hyperalgesia and nociceptor-driven spinal sensitization in the rat. Anesthesiology. 1994; 80(2): 383–91; discussion 25A, indexed in Pubmed: 8311320.
Rowlingson JC, DiFazio CA, Foster J, et al. Lidocaine as an analgesic for experimental pain. Anesthesiology. 1980; 52(1): 20–22, indexed in Pubmed: 7352640. 63. Boas RA, [
Dirks J, Fabricius P, Petersen KL, et al. The effect of systemic lidocaine on pain and secondary hyperalgesia associated with the heat/capsaicin sensitization model in healthy volunteers. Anesth Analg. 2000; 91(4): 967–972, indexed in Pubmed: 11004058.
Araujo MC, Sinnott CJ, Strichartz GR. Multiple phases of relief from experimental mechanical allodynia by systemic lidocaine: responses to early and late infusions. Pain. 2003; 103(1-2): 21–29, indexed in Pubmed: 12749955
Houweling PL, Molag ML, van Boekel RLM, et al. Postoperative pain treatment’ practice guideline revised. Ned Tijdschr Geneeskd. 2013; 157(49): A7005, indexed in Pubmed: 24299631.
Marret E, Rolin M, Beaussier M, et al. Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery. Br J Surg. 2008; 95(11): 1331–1338, doi: 10.1002/bjs.6375, indexed in Pubmed: 18844267.
Vigneault L, Turgeon AF, Côté D, et al. Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. Can J Anaesth. 2011; 58(1): 22–37, doi: 10.1007/s12630-010-9407-0, indexed in Pubmed: 21061107.
Gonda X. Basic pharmacology of NMDA receptors. Curr Pharm Des. 2012; 18(12): 1558–1567, indexed in Pubmed: 22280436
Blaudszun G, Lysakowski C, Elia N, et al. Effect of perioperative systemic a2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials. Anesthesiology. 2012; 116(6): 1312–1322, doi: 10.1097/ ALN.0b013e31825681cb, indexed in Pubmed: 22546966.
Bernard JM, Hommeril JL, Passuti N, et al. Postoperative analgesia by intravenous clonidine. Anesthesiology. 1991; 75(4): 577–582, indexed
Zhang J, Ho KY, Wang Y. Efficacy of pregabalin in acute postoperative pain: a meta-analysis. Br J Anaesth. 2011; 106(4): 454–462, doi: 10.1093/ bja/aer027, indexed in Pubmed: 21357616.
Gonda X. Basic pharmacology of NMDA receptors. Curr Pharm Des. 2012; 18(12): 1558–1567, indexed in Pubmed: 2228043
Petrenko AB, Yamakura T, Sakimura K, et al. Defining the role of NMDA receptors in anesthesia: are we there yet? Eur J Pharmacol. 2014; 723: 29–37, doi: 10.1016/j.ejphar.2013.11.039, indexed in Pubmed: 24333550.
Murphy JD, Paskaradevan J, Eisler LL, et al. Analgesic efficacy of continuous intravenous magnesium infusion as an adjuvant to morphine for postoperative analgesia: a systematic review and meta-analysis. Middle East J Anaesthesiol. 2013; 22(1): 11–20, indexed in Pubmed: 2383384
Oliveira GDe, Almeida M, Benzon H, et al. Perioperative single dose systemic dexamethasone for postoperative pain. Anesthesiology. 2011; 115(3): 575–588, doi: 10.1097/aln.0b013e31822a24c2
Gorlin AW, Rosenfeld DM, Ramakrishna H. Intravenous sub-anesthetic ketamine for perioperative analgesia. J Anaesthesiol Clin Pharmacol. 2016; 32(2): 160–167, doi: 10.4103/0970-9185.182085, indexed in Pubmed: 27275042.
Gorlin AW, Rosenfeld DM, Ramakrishna H. Intravenous sub-anesthetic ketamine for perioperative analgesia. J Anaesthesiol Clin Pharmacol. 2016; 32(2): 160–167, doi: 10.4103/0970-9185.182085, indexed in Pubmed: 27275042.
Iacobucci GJ, Visnjevac OPourafkari L, et al. Ketamine: an update on cellular and subcellular mechanisms with implications for clinical practice. Pain Physician. 2017; 20(2): E285–E301, indexed in Pubmed: 28158165.
Parashchanka A, Schelfout S, Coppens M. Role of novel drugs in sedation outside the operating room: dexmedetomidine, ketamine and remifentanil. Curr Opin Anaesthesiol. 2014; 27(4): 442–447, doi: 10.1097/ACO.0000000000000086, indexed in Pubmed: 24762954.
Ali HM, Mokhtar AM. Effect of single compared to repeated doses of intravenous S(+) ketamine on the release of pro-inflammatory cytokines in patients undergoing radical prostatectomy. Anesth Essays Res. 2017; 11(2): 282–286, doi: 10.4103/aer.AER_28_17, indexed in Pubmed: 28663607
Vadivelu N, Schermer E, Kodumudi V, et al. Role of ketamine for analgesia in adults and children. J Anaesthesiol Clin Pharmacol. 2016; 32(3): 298–306, doi: 10.4103/0970-9185.168149, indexed in Pubmed: 27625475.
Haile CN, Murrough JW, Iosifescu DV, et al. Plasma brain derived neurotrophic factor (BDNF) and response to ketamine in treatment-resistant depression. Int J Neuropsychopharmacol. 2014; 17(2): 331–336, doi: 10.1017/S1461145713001119, indexed in Pubmed: 24103211.
Kelmendi B, Adams TG, Yarnell S, et al. PTSD: from neurobiology to pharmacological treatments. Eur J Psychotraumatol. 2016; 7: 31858, indexed in Pubmed: 27837583.
Pourmand A, Mazer-Amirshahi M, Royall C, et al. Low dose ketamine use in the emergency department, a new direction in pain management. Am J Emerg Med. 2017; 35(6): 918–921, doi: 10.1016/j.ajem.2017.03.005, indexed in Pubmed: 28285863
Petz L, Tyner S, Barnard Ed, et al. Prehospital and en route analgesic use in the combat setting: a prospectively designed, multicenter, observational study. Military Medicine. 2015; 180(3S): 14–18, doi: 10.7205/milmed-d-14-00383
Mihaljević S, Pavlović M, Reiner K, Ćaćić M. Therapeutic Mechanisms of Ketamine. Psychiatr Danub. 2020 Autumn-Winter;32(3-4):325-333. doi: 10.24869/psyd.2020.325. PMID: 33370729.
Jerzy Wordliczek1, 2, Renata Zajączkowska3, 4, Jan Dobrogowski1, 2Farmakologiczne leczenie bólu neuropatycznego Polski Przegląd Neurologiczny 2011, tom 7, 1, 39–48
Stahl S.M., Stahl’s essential psychopharmacology. Cambridge University Press, Cambridge 2013.
Jarosław Woroń1,2, Anna Adamczyk3, Małgorzata Malec-Milewska4, Joanna Jakowicka-Wordliczek5 Stosowanie koanalgetyków u pacjentów z bólem neuropatycznym w przebiegu choroby nowotworowej Palliative Medicine in Practice Vol 8, No 2 (2014)
Aiyer R, Barkin RL, Bhatia A. Treatment of Neuropathic Pain with Venlafaxine: A Systematic Review. Pain Med. 2017 Oct 1;18(10):1999-2012. doi: 10.1093/pm/pnw261. PMID: 27837032.
de Oliveira Filho GR, Kammer RS, Dos Santos HC. Duloxetine for the treatment acute postoperative pain in adult patients: A systematic review with meta-analysis. J Clin Anesth. 2020 Aug;63:109785. doi: 10.1016/j.jclinane.2020.109785. Epub 2020 Mar 14. PMID: 32179396.
Schnabel A, Weibel S, Reichl SU, Meißner M, Kranke P, Zahn PK, Pogatzki-Zahn EM, Meyer-Frießem CH. Efficacy and adverse events of selective serotonin noradrenaline reuptake inhibitors in the management of postoperative pain: A systematic review and meta-analysis. J Clin Anesth. 2021 Dec;75:110451. doi: 10.1016/j.jclinane.2021.110451. Epub 2021 Jul 23. PMID: 34311244.
Walitt B, Urrútia G, Nishishinya MB, Cantrell SE, Häuser W. Selective serotonin reuptake inhibitors for fibromyalgia syndrome. Cochrane Database Syst Rev. 2015 Jun 5;2015(6):CD011735. doi: 10.1002/14651858.CD011735. PMID: 26046493; PMCID: PMC4755337.
Plein LM, Rittner HL. Opioids and the immune system — friend or foe. Br J Pharmacol. 2018; 175(14): 2717–2725, doi: 10.1111/bph.13750, indexed in Pubmed: 28213891. 123. [46]Weber L, Yeomans DC, Tzabazis A. Opioid-induced hyperalgesia in clinical anesthesia practice: what has remained from theoretical concepts and experimental studies? Curr Opin Anaesthesiol. 2017; 30(4): 458–465, doi: 10.1097/ACO.0000000000000485, indexed in Pubmed: 28590258.
Ziemann-Gimmel P, Goldfarb AA, Koppman J, et al. Opioid-free total intravenous anaesthesia reduces postoperative nausea and vomiting in bariatric surgery beyond triple prophylaxis. Br J Anaesth. 2014; 112(5): 906–911, doi: 10.1093/bja/aet551, indexed in Pubmed: 24554545.
Cata JP, Bugada D, De Andrés J. Opioid less perioperative care. Minerva Anestesiol. 2017; 83(3): 315–320, indexed in Pubmed: 27824241.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Olga Wysokińska, Justyna Żyga, Anna Małek, Karolina Zadrożna, Klara Iwaniszyn-Zapołoch
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 1466
Number of citations: 0
