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Medicina 2018, 54(2), 20; https://doi.org/10.3390/medicina54020020

Role of Multimodal Analgesia in the Evolving Enhanced Recovery after Surgery Pathways

1
Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy Lithuanian University of Health Sciences, Kaunas 50009, Lithuania
2
Department of Anaesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas 50009, Lithuania
3
Department of Internal Diseases, Medical Academy, Lithuanian University of Health Sciences, Kaunas 50009, Lithuania
*
Author to whom correspondence should be addressed.
Received: 21 February 2018 / Revised: 10 April 2018 / Accepted: 18 April 2018 / Published: 23 April 2018
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Abstract

Enhanced recovery after surgery (ERAS) are specially designed multimodal perioperative care pathways which are intended to attain and improve rapid recovery after surgical interventions by supporting preoperative organ function and attenuating the stress response caused by surgical trauma, allowing patients to get back to normal activities as soon as possible. Evidence-based protocols are prepared and published to implement the conception of ERAS. Although they vary amongst health care institutions, the main three elements (preoperative, perioperative, and postoperative components) remain the cornerstones. Postoperative pain influences the quality and length of the postoperative recovery period, and later, the quality of life. Therefore, the optimal postoperative pain management (PPM) applying multimodal analgesia (MA) is one of the most important components of ERAS. The main purpose of this article is to discuss the concept of MA in PPM, particularly reviewing the use of opioid-sparing measures such as paracetamol, nonsteroid anti-inflammatory drugs (NSAIDs), other adjuvants, and regional techniques. View Full-Text
Keywords: enhanced recovery after surgery; multimodal analgesia; postoperative pain; NSAIDs enhanced recovery after surgery; multimodal analgesia; postoperative pain; NSAIDs
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Gelman, D.; Gelmanas, A.; Urbanaitė, D.; Tamošiūnas, R.; Sadauskas, S.; Bilskienė, D.; Naudžiūnas, A.; Širvinskas, E.; Benetis, R.; Macas, A. Role of Multimodal Analgesia in the Evolving Enhanced Recovery after Surgery Pathways. Medicina 2018, 54, 20.

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