Commentary: Role of pre-emptive analgesia in reversing the opioid epidemic

  • Mohamed K. Kamel
    Address for reprints: Mohamed K. Kamel, MD, Department of General Surgery, Central Michigan University College of Medicine, 912 S Washington Ave, STE 1, Saginaw, MI 48601.
    Department of General Surgery, Central Michigan University College of Medicine, Saginaw, Mich
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Published:November 19, 2019DOI:
      The use of pre-emptive analgesia following minimally invasive foregut surgery can significantly decrease opioid prescriptions at discharge, yet with no compromise in the adequacy of pain control.
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        • Crile G.W.
        The kinetic theory of shock and its prevention through anoci-association (shockless operation).
        Lancet. 1913; 182: 7-16
        • Woolf C.J.
        • Wall P.D.
        Morphine-sensitive and morphine-insensitive actions of C-fibre input on the rat spinal cord.
        Neurosci Lett. 1986; 64: 221-225
        • Woolf C.J.
        • Chong M.-S.
        Preemptive analgesia—treating postoperative pain by preventing the establishment of central sensitization.
        Anesth Analg. 1993; 77: 362-379
        • Pogatzki-Zahn E.M.
        • Zahn P.K.
        From preemptive to preventive analgesia.
        Curr Opin Anesthesiol. 2006; 19: 551-555
        • Gostin L.O.
        • Hodge J.G.
        • Noe S.A.
        Reframing the opioid epidemic as a national emergency.
        JAMA. 2017; 318: 1539-1540
        • Johnson K.
        • Jones C.
        • Compton W.
        • Baldwin G.
        • Fan J.
        • Mermin J.
        • et al.
        Federal response to the opioid crisis.
        Curr HIV/AIDS Rep. 2018; 15: 293-301
        • Trabulsi E.J.
        • Patel J.
        • Viscusi E.R.
        • Gomella L.G.
        • Lallas C.D.
        Preemptive multimodal pain regimen reduces opioid analgesia for patients undergoing robotic-assisted laparoscopic radical prostatectomy.
        Urology. 2010; 76: 1122-1124
        • Al-Mujadi H.
        • A-Refai A.R.
        • Katzarov M.G.
        • Dehrab N.A.
        • Batra Y.K.
        • Al-Qattan A.R.
        Preemptive gabapentin reduces postoperative pain and opioid demand following thyroid surgery.
        Can J Anesth. 2006; 53: 268-273
        • Kim M.P.
        • Godoy C.
        • Nguyen D.T.
        • Meisenbach L.M.
        • Chihara R.
        • Chan E.Y.
        • et al.
        Preemptive pain-management program is associated with reduction of opioid prescriptions after benign minimally invasive foregut surgery.
        J Thorac Cardiovasc Surg. 2020; 159: 734-744.e4

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