Management of postoperative pain in non traumatic emergency surgery: WSES guidelines
Written By : Medha Baranwal
Medically Reviewed By : Dr. Kamal Kant Kohli
Published On 2022-10-14 05:30 GMT | Update On 2022-10-14 09:54 GMT
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Italy: Four organizations in collaboration have released clinical guidelines on managing postoperative pain in nontraumatic emergency surgery.
The clinical guidelines, published in the World Journal of Emergency Surgery, were released jointly by the Global Alliance for Infection in Surgery (GAIS), World Society of Emergency Surgery (WSES), Analgesia Intensive Care (SIAARTI), Italian Society of Anesthesia, and American Association for the Surgery of Trauma (AAST).
Nonopioid and Opioid Drugs
- The use of opiates should be reduced as much as possible. Multimodal analgesia should always be considered; a step-up approach that includes significant opiates when necessary should be adopted.
- In the absence of contraindications, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and gabapentinoids are recommended in multimodal analgesia. Acetaminophen given at the start of postoperative analgesia may be superior. Coxibs may be considered if there are no contraindications.
- Major opiates are indicated for moderate-to-severe pain, unresponsive to other drugs, and in which regional anesthesia is not indicated.
- In opioid-naïve patients, initial opioid infusion via intravenous (IV) patient-controlled analgesia (PCA) should be avoided. If indicated, opiate infusion via IV PCA should be preferred to spinal PCA whenever the IV route is viable.
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