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Vol. 64. Issue 8.
Pages 467-471 (October 2017)
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Vol. 64. Issue 8.
Pages 467-471 (October 2017)
Continuing education
Pharmacological advances in the multimodal management of perioperative analgesia
Avances farmacológicos en el manejo multimodal de la analgesia perioperatoria
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M. Matute Crespo, A. Montero Matamala
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Servicio de Anestesiología, Reanimación y clínica del Dolor, Hospital Universitario Arnau de Vilanova, Lleida, Spain
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Abstract

The concept of multimodal analgesia is currently widespread in our clinical practice.

The aim of multimodal analgesia is to reduce the side effects derived from the drugs or techniques used for the control of pain together with greater effectiveness (combination of multiple mechanisms of action) with the maximum efficiency, that is, to combine different pharmacodynamics (synergistic or additive effects) and pharmacokinetics, in the context of a predictable acute pain model, thus allowing a prior strategy such as the model of acute postoperative pain.

Pain is a complex physiological phenomenon. Postoperative pain involves multiple pathways including nociceptive, inflammatory, and neuropathic sources. In the transmission of pain therefore, different molecules participate, which means that there are multiple pharmacological targets on which to act, and therefore a wide range of drugs to be used following the physiology of pain.

Keywords:
Perioperative analgesia
Multimodal analgesia
Analgesic advances
Resumen

El concepto de analgesia multimodal está actualmente muy extendido en nuestra práctica clínica.

El objetivo de la analgesia multimodal es la disminución de efectos secundarios derivados de los fármacos o técnicas utilizados para el control del dolor junto a una mayor efectividad (combinación de múltiples mecanismos de acción) con la máxima eficiencia, es decir, combinar diferentes farmacodinamias (efectos sinérgicos o aditivos) y farmacocinéticas en el contexto de un modelo de dolor agudo previsible y por lo tanto que nos permite una estrategia previa como es el modelo del dolor agudo postoperatorio.

El dolor es un fenómeno fisiológico complejo. En el dolor postoperatorio intervienen múltiples vías incluyendo fuentes nociceptivas, inflamatorias y neuropáticas. En la transmisión del dolor por lo tanto, participan distintas moléculas; este hecho supone que existen múltiples dianas farmacológicas sobre las que actuar y por lo tanto una amplio abanico de fármacos a utilizar siguiendo la fisiología del dolor.

Palabras clave:
Analgesia perioperatoria
Analgesia multimodal
Avances analgésicos

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