Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
9092626 | Best Practice & Research Clinical Anaesthesiology | 2005 | 18 Pages |
Abstract
The chronic pain patient has certain distinctive features important for her/his perioperative management. Altered opioid sensitivity and behavior are the major points to be considered. The pre-anesthetic visit should therefore include questions regarding chronic pain and regular use of analgesics and coanalgesics, among others. Although a number of characteristics-including increased opioid demand, underreporting of pain, and non-compliance-are known, only a few specific recommendations are available, viz. adequate increase of opioid dose for analgesia, continuation of pre-operative opioids and coanalgesics to prevent withdrawal, and intensive education to strengthen the patient's coping potential. No differences between specific techniques for post-operative analgesia (e.g. systemic, patient-controlled or regional analgesia) have been shown so far.
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Authors
Andreas (Director, Pain Clinic), Anne (Senior Resident in Anesthesia), Christoph (Professor of Anesthesiology and Chairman),