Acute Pain Management

Why does acute pain management matter?

Reduce complications

Effective postoperative acute pain control can reduce complications such as pneumonia, deep vein thrombosis, infection, chronic pain and depression[3]

Prevent chronic pain

Adequate postoperative acute pain control can effectively prevent the development of chronic pain[4]

Improve patients’ quality of life

Patients’ quality of life can be greatly improved by the management of acute postoperative pain[5]

How does Naldebain prevent chronic post-surgical pain (CPSP)*?

The most consistent feature associated with the occurrence of CPSP is the duration of the severe acute postoperative pain.   Acute pain leads to central sensitization, reduces the mechanical threshold and exaggerates the response to noxious stimuli, which causes an intensification of acute pain and long-term postoperative pain[6].

Note: Chronic post-surgical pain (CPSP): pain develops after surgical intervention and lasts at least 2 months

Cautious and thoughtful perioperative pain planning is necessary as preoperative pain, additional painful noxious intraoperative inputs such as retraction and postoperative inflammatory processes can all cause acute pain and CPSP[7].

Naldebain can be used in combination with either morphine or NSAID for management of moderate to severe postoperative pain and inhibition of CPSP development.

For the graph shown below, the blue dotted line represents Naldebain + Multimodal Analgesic (MMA); it provides preventive analgesia and global perioperative pain processing coverage, which shows excellent intraoperative and postoperative analgesic efficacy (pain intensity < 3), and thus reduces the CPSP[4].

New concepts and trends in acute pain management

Enhanced Recovery after Surgery (ERAS):
  • The aims of  ERAS are to attenuate the stress response to surgery and to enable rapid recovery[8].
    One of the major elements of an ERAS pathway is the provision of dynamic postoperative acute pain management.
  • The benefits of ERAS:
    ◇The length of hospital stays were significantly reduced by 2.5 days on average
    ◇There was an almost 50% reduction in complication rates
Multimodal Analgesic(MMA):
Postoperative pain is a complex and multifactorial phenomenon. 
  • MMA involves the use of multiple mechanisms of pain control acting synergistically to improve analgesic effect and reduce the doses of any single agent to minimize the risks of side-effects.
  • MMA is an important management practice for enhanced recovery after surgery (ERAS).  It improves postoperative pain management and results in  shorter hospital stays [4] .

Video

Introduction of Naldebain

Dr. Sing-Ong Lee

Minimally Invasive Surgery

Dr. Sing-Ong Lee