An Update on Nonopioids: Intravenous or Oral Analgesics for Perioperative Pain Management

Alan D Kaye; Elyse M Cornett; Erik Helander; Bethany Menard; Eric Hsu; Brendon Hart; Andrew Brunk

doi:10.1016/j.anclin.2017.01.006

An Update on Nonopioids: Intravenous or Oral Analgesics for Perioperative Pain Management

Anesthesiol Clin. 2017 Jun;35(2):e55-e71. doi: 10.1016/j.anclin.2017.01.006. Epub 2017 Mar 30.

Authors

Alan D Kaye¹, Elyse M Cornett², Erik Helander³, Bethany Menard³, Eric Hsu⁴, Brendon Hart², Andrew Brunk³

Affiliations

¹ Department of Anesthesiology, LSU School of Medicine, 1542 Tulane Avenue, New Orleans, LA 70112, USA; Department of Pharmacology, Louisiana State University School of Medicine, Louisiana State University Health Science Center, 1542 Tulane Avenue, New Orleans, LA 70112, USA. Electronic address: alankaye44@hotmail.com.
² Department of Anesthesiology, LSU School of Medicine, 1501 Kings Highway, Shreveport, LA 71130, USA.
³ Department of Anesthesiology, LSU School of Medicine, 1542 Tulane Avenue, New Orleans, LA 70112, USA.
⁴ Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, UCLA School of Medicine, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 3325, Los Angeles, CA 90095-7403, USA.

PMID: 28526161
DOI: 10.1016/j.anclin.2017.01.006

Abstract

Despite an appreciation for many unwanted physiologic effects from inadequate postoperative pain relief, moderate to severe postoperative pain remains commonplace. Although treatment options have evolved in recent years, the use of nonopioid analgesics agents can reduce acute pain-associated morbidity and mortality. This review focuses on the importance of effective postoperative nonopioid analgesic agents, such as acetaminophen, nonsteroidal anti-inflammatory agents, gabapentinoid agents, NMDA antagonists, alpha 2 agonists, and steroids, in opioid sparing and enhancing recovery. A careful literature review focusing on these treatment options, potential benefits, and side effects associated with these strategies is emphasized in this review.

Keywords: Acetaminophen; Acute pain; Gabapentin; Ketamine; Multimodal analgesia; NMDA antagonists; Nonsteroidals; Regional anesthesia.

Publication types

Review

MeSH terms

Acetaminophen / administration & dosage
Acute Pain / drug therapy*
Analgesics, Non-Narcotic / administration & dosage*
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
Drug Therapy, Combination
Humans
Pain, Postoperative / drug therapy*

Substances

Analgesics, Non-Narcotic
Anti-Inflammatory Agents, Non-Steroidal
Acetaminophen