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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2002 June;26(2):97-104
Preemptive and balanced analgesia for postoperative pain in foot surgery
Napoli V., Napoli E.
Postoperative pain is generated by the stimulation of the nocireceptors via inflammatory mediators, such as prostaglandins, bradykinins and serotonin, released in tissues injured by surgical intervention. Also, these substances induce central and peripheral sensitization of other mediators, thus increasing the perception and intensity of pain. Optimum postoperative pain management should be aimed at counteracting their effect on the nocireceptors and at reducing sensitization phenomena. This study proposes a technique for preemptive and balanced analgesia for postoperative pain in foot surgery. The technique was clinically evaluated on 50 patients who received elective surgery for hallus valgus, with the use of two analgesic agents at various operating times. In pre-anesthesia, patients were administered buprenorphine (0.2 mg), an opiod analgesic with prolonged action that saturates the central receptors of algogenic stimuli. Shortly before and after the end of the operation, patients received Ketorolac (30 mg), a peripheral anti-inflammatory agent that inhibits the synthesis of prostaglandin and other pain mediators. Clinical results showed marked reduction in pain intensity and duration, with overall absence of side effects in almost all patients, thus confirming the effectiveness of the suggested method.