Research ArticleOPIOID STEWARDSHIP

An Evidence-Based Opioid-Free Anesthetic Technique to Manage Perioperative and Periprocedural Pain

Philip G. Boysen, Marisa M. Pappas and Bryan Evans
Ochsner Journal June 2018, 18 (2) 121-125; DOI: https://doi.org/10.31486/toj.17.0072

REFERENCES

  1. 1.↵
    Centers for Disease Control and Prevention. Drug overdose deaths in the United States continue to increase in 2015. www.cdc.gov/drugoverdose/epidemic/index.html. Accessed August 3, 2017.
  2. 2.↵
    1. Korn M,
    2. Kamp J
    . Fatal student opioid overdoses prompt colleges to action. The Wall Street Journal. https://www.wsj.com/articles/colleges-take-action-on-opioid-epidemic-1494158403. Published May 7, 2017. Accessed November 15, 2017.
  3. 3.↵
    1. Fecho K,
    2. Lunney AT,
    3. Boysen PG,
    4. Rock P,
    5. Norfleet EA
    . Postoperative mortality after inpatient surgery: incidence and risk factors. Ther Clin Risk Manag. 2008 Aug;4(4):681-688.
    OpenUrlPubMed
  4. 4.↵
    1. Brummett CM,
    2. Waljee JF,
    3. Goesling J,
    4. et al.
    New persistent opioid use after minor and major surgical procedures in US adults. JAMA Surg. 2017 Jun 21;152(6):e170504. doi: 10.1001/jamasurg.2017.0504.
    OpenUrlCrossRefPubMed
  5. 5.↵
    1. Dowell D,
    2. Haegerich TM,
    3. Chou R
    . CDC guideline for prescribing opioids for chronic pain—United States, 2016. JAMA. 2016 Apr 19;315(15):1624-1645. doi: 10.1001/jama.2016.1464.
    OpenUrlCrossRefPubMed
  6. 6.↵
    1. Birkmeyer JD
    . Progress and challenges in improving surgical outcomes. Br J Surg. 2012 Nov;99(11):1467-1469. doi: 10.1002/bjs.8933.
    OpenUrlCrossRefPubMed
  7. 7.↵
    1. Lundy JS
    . Balanced anesthesia. Minnesota Med. 1926;9:399-404.
    OpenUrl
  8. 8.↵
    1. Lundy JS
    . Useful anesthetic agents and methods. JAMA. 1931;97(1):25-31. doi: 10.1001/jama.1931.27310010003010.
    OpenUrlCrossRef
  9. 9.↵
    1. Kehlet H,
    2. Dahl JB
    . The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg. 1993 Nov;77(5):1048-1056.
    OpenUrlPubMedWeb of Science
  10. 10.↵
    1. Woolf CJ,
    2. Chong MS
    . Preemptive analgesia—treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg. 1993 Aug;77(2):362-379.
    OpenUrlCrossRefPubMedWeb of Science
  11. 11.↵
    1. Groudine SB,
    2. Fisher HA,
    3. Kaufman RP Jr.,
    4. et al.
    Intravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy. Anesth Analg. 1998 Feb;86(2):235-239.
    OpenUrlPubMedWeb of Science
  12. 12.↵
    1. Herroeder S,
    2. Pecher S,
    3. Schönherr ME,
    4. et al.
    Systemic lidocaine shortens length of hospital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial. Ann Surg. 2007 Aug;246(2):192-200. Erratum in: Ann Surg. 2009 Apr;249(4):701.
    OpenUrl
  13. 13.↵
    1. Butterworth JF 4th.,
    2. Strichartz GR
    . Molecular mechanisms of local anesthesia: a review. Anesthesiology. 1990 Apr;72(4):711-734.
    OpenUrlCrossRefPubMedWeb of Science
  14. 14.↵
    1. Narang PK,
    2. Crouthamel WG,
    3. Carliner NH,
    4. Fisher ML
    . Lidocaine and its active metabolites. Clin Pharmacol Ther. 1978 Dec;24(6):654-662.
    OpenUrlCrossRefPubMedWeb of Science
  15. 15.↵
    1. Vigneault L,
    2. Turgeon AF,
    3. Côté D,
    4. et al.
    Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. Can J Anaesth. 2011 Jan;58(1):22-37. doi: 10.1007/s12630-010-9407-0.
    OpenUrlCrossRefPubMedWeb of Science
  16. 16.↵
    1. Yardeni IZ,
    2. Beilin B,
    3. Mayburd E,
    4. Levinson Y,
    5. Bessler H
    . The effect of perioperative intravenous lidocaine on postoperative pain and immune function. Anesth Analg. 2009 Nov;109(5):1464-1469. doi: 10.1213/ANE.0b013e3181bab1bd.
    OpenUrlCrossRefPubMedWeb of Science
  17. 17.↵
    1. Okada S,
    2. Hagan JB,
    3. Kato M,
    4. et al.
    Lidocaine and its analogues inhibit IL-5-mediated survival and activation of human eosinophils. J Immunol. 1998 Apr 15;160(8):4010-4017.
    OpenUrlAbstract/FREE Full Text
  18. 18.↵
    1. MacGregor RR,
    2. Thorner RE,
    3. Wright DM
    . Lidocaine inhibits granulocyte adherence and prevents granulocyte delivery to inflammatory sites. Blood. 1980 Aug;56(2):203-209.
    OpenUrlFREE Full Text
  19. 19.↵
    1. Angst MS,
    2. Clark JD
    . Opioid-induced hyperalgesia: a qualitative systematic review. Anesthesiology. 2006 Mar;104(3):570-587.
    OpenUrlCrossRefPubMedWeb of Science
  20. 20.↵
    1. Lee M,
    2. Silverman SM,
    3. Hansen H,
    4. Patel VB,
    5. Manchikanti L
    . A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011 Mar-Apr;14(2):145-161.
    OpenUrlPubMedWeb of Science
  21. 21.↵
    1. Peat MA,
    2. Deyman ME,
    3. Crouch DJ,
    4. Margot P,
    5. Finkle BS
    . Concentrations of lidocaine and monoethylglycylxylidide (MEGX) in lidocaine associated deaths. J Forensic Sci. 1985 Oct;30(4):1048-1057.
    OpenUrlPubMed
  22. 22.↵
    1. Kamibayashi T,
    2. Maze M
    . Clinical uses of alpha 2-adrenergic agonists. Anesthesiology. 2000 Nov;93(5):1345-1349.
    OpenUrlCrossRefPubMedWeb of Science
  23. 23.↵
    1. Sandler AN
    . The role of clonidine and alpha 2-agonists for postoperative analgesia. Can J Anaesth. 1996 Dec;43(12):1191-1194.
    OpenUrlPubMed
  24. 24.↵
    1. Ramsay MA,
    2. Luterman DL
    . Dexmedetomidine as a total intravenous anesthetic agent. Anesthesiology. 2004 Sep;101(3):787-790.
    OpenUrlCrossRefPubMedWeb of Science
  25. 25.↵
    1. Aantaa R,
    2. Jaakola ML,
    3. Kallio A,
    4. Kanto J
    . Reduction of the minimum alveolar concentration of isoflurane by dexmedetomidine. Anesthesiology. 1997 May;86(5):1055-1060.
    OpenUrlCrossRefPubMedWeb of Science
  26. 26.↵
    1. Jalonen J,
    2. Hynynen M,
    3. Kuitunen A,
    4. et al.
    Dexmedetomidine as an anesthetic adjunct in coronary artery bypass grafting. Anesthesiology. 1997 Feb;86(2):331-345.
    OpenUrlCrossRefPubMedWeb of Science
  27. 27.↵
    1. Levänen J,
    2. Mäkelä ML,
    3. Scheinin H
    . Dexmedetomidine premedication attenuates ketamine-induced cardiostimulatory effects and postanesthetic delirium. Anesthesiology. 1995 May;82(5):1117-1125.
    OpenUrlCrossRefPubMedWeb of Science
  28. 28.↵
    1. Li L,
    2. Vlisides PE
    . Ketamine: 50 years of modulating the mind. Front Hum Neurosci. 2016 Nov 29;10:612. eCollection 2016.
    OpenUrl
  29. 29.↵
    1. Guillou N,
    2. Tanguy M,
    3. Seguin P,
    4. Branger B,
    5. Campion JP,
    6. Mallédant Y
    . The effects of small-dose ketamine on morphine consumption in surgical intensive care unit patients after major abdominal surgery. Anesth Analg. 2003 Sep;97(3):843-847.
    OpenUrlPubMedWeb of Science
  30. 30.↵
    1. Ward B,
    2. Alexander-Williams JM
    . Paracetamol revisited: a review of the pharmacokinetics and pharmacodynamics. Acute Pain. 1999 Sep;2(3):139-149.
    OpenUrl
  31. 31.↵
    1. Memis D,
    2. Inal MT,
    3. Kavalci G,
    4. Sezer A,
    5. Sut N
    . Intravenous paracetamol reduced the use of opioids, extubation time, and opioid-related adverse effects after major surgery in intensive care unit. J Crit Care. 2010 Sep;25(3):458-462. doi: 10.1016/j.jcrc.2009.12.012.
    OpenUrlCrossRefPubMed
  32. 32.↵
    1. Forrest JA,
    2. Clements JA,
    3. Prescott LF
    . Clinical pharmacokinetics of paracetamol. Clin Pharmacokinet. 1982 Mar-Apr;7(2):93-107.
    OpenUrlCrossRefPubMedWeb of Science
  33. 33.↵
    1. Anderson BJ
    . Paracetamol (acetaminophen): mechanisms of action. Paediatr Anaesth. 2008 Oct;18(10):915-921. doi: 10.1111/j.1460-9592.2008.02764.x.
    OpenUrlCrossRefPubMed
  34. 34.↵
    1. Wong I,
    2. St John-Green C,
    3. Walker SM
    . Opioid-sparing effects of perioperative paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in children. Paediatr Anaesth. 2013 Jun;23(6):475-495. doi: 10.1111/pan.12163.
    OpenUrlCrossRef
  35. 35.↵
    1. O'Hara DA,
    2. Fragen RJ,
    3. Kinzer M,
    4. Pemberton D
    . Ketorolac tromethamine as compared with morphine sulfate for treatment of postoperative pain. Clin Pharmacol Ther. 1987 May;41(5):556-561.
    OpenUrlCrossRefPubMedWeb of Science
  36. 36.↵
    1. Jung D,
    2. Mroszczak E,
    3. Bynum L
    . Pharmacokinetics of ketorolac tromethamine in humans after intravenous, intramuscular and oral administration. Eur J Clin Pharmacol. 1988;35(4):423-425.
    OpenUrlCrossRefPubMedWeb of Science
  37. 37.↵
    1. Olkkola KT,
    2. Maunuksela EL
    . The pharmacokinetics of postoperative intravenous ketorolac tromethamine in children. Br J Clin Pharmacol. 1991 Feb;31(2):182-184.
    OpenUrlCrossRefPubMedWeb of Science
  38. 38.↵
    1. Bookstaver PB,
    2. Miller AD,
    3. Rudisill CN,
    4. Norris LB
    . Intravenous ibuprofen: the first injectable product for the treatment of pain and fever. J Pain Res. 2010 May 25;3:67-79.
    OpenUrlPubMed
  39. 39.↵
    1. Smith HS,
    2. Voss B
    . Pharmacokinetics of intravenous ibuprofen: implications of time of infusion in the treatment of pain and fever. Drugs. 2012 Feb 12;72(3):327-337. doi: 10.2165/11599230-000000000-00000.
    OpenUrlCrossRefPubMed
  40. 40.↵
    1. Weinberg GL,
    2. Di Gregorio G,
    3. Ripper R,
    4. et al.
    Resuscitation with lipid versus epinephrine in a rat model of bupivacaine overdose. Anesthesiology. 2008 May;108(5):907-913. doi: 10.1097/ALN.0b013e31816d91d2.
    OpenUrlCrossRefPubMedWeb of Science
  41. 41.↵
    1. Ciechanowicz S,
    2. Patil V
    . Lipid emulsion for local anesthetic systemic toxicity. Anesthesiol Res Pract. 2012;2012:131784. doi: 10.1155/2012/131784.
    OpenUrlCrossRefPubMed
  42. 42.↵
    1. Weinberg GL
    . Lipid infusion therapy: translation to clinical practice. Anesth Analg. 2008 May;106(5):1340-1342. doi: 10.1213/ane.0b013e31816a6c09.
    OpenUrlCrossRefPubMedWeb of Science
  43. 43.↵
    1. Paetzold J,
    2. Boysen PG
    . Opioid sparing anesthetic: a preliminary cost and feasibility. Anesth Analg. 2017 May;124 (5S Suppl):947-948.
    OpenUrl
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