Skip Navigation LinksHome > October 2014 - Volume 27 - Issue 5 > Nonopioid analgesics for postoperative pain management
Current Opinion in Anaesthesiology:
doi: 10.1097/ACO.0000000000000113
PAIN MEDICINE: Edited by Esther Pogatzki-Zahn

Nonopioid analgesics for postoperative pain management

Pogatzki-Zahn, Esthera; Chandrasena, Chandanib; Schug, Stephan A.b,c

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Abstract

Purpose of review

Postoperative pain remains poorly treated in many patients. One reason is the inadequate use of nonopioid analgesics. This review examines the most recent findings on nonopioid analgesics and how these translate into clinical practice.

Recent findings

Commonly used nonopioid analgesics are paracetamol, NSAIDs and metamizol (dipyrone). For paracetamol, the efficacy is obviously inferior to NSAIDs and the risk of adverse events might have been underestimated in the past. For NSAIDs, there are increasing data supporting similar efficacy of nonselective and cyclooxygenase-2 selective NSAIDs, although the adverse effects of the latter might make them the preferred option for short-term use in the perioperative setting. Metamizol (dipyrone) is a very effective nonopioid analgesic not worldwide available; the discussion on the relevance of the very rare adverse event agranulocytosis continues.

Summary

Nonopioid analgesics are important components of multimodal postoperative analgesia. The selection of the most appropriate compound for an individual patient can be based more and more on ever increasing data on these important analgesics.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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