Abstract | BACKGROUND: Inadequate pain control and opioid-related adverse effects result in delayed patient recovery and discharge times. Adjuvants help to improve the quality of analgesia and decrease opioid consumption, consequently decreasing opioid-related effects, such as nausea and vomiting, sedation, ileus, and respiratory depression. We review the mechanisms and clinical evidence for nonopioid adjuvants. METHODS: MEDLINE, EMBASE, and the Cochrane Register were searched for meta-analyses, systematic reviews, and randomized, controlled trials that compared the adjuvants ketamine, gabapentin, pregabalin, dexmedetomidine, clonidine, and dexamethasone with placebo. Keywords used in the search included "plastic surgery," "reconstructive surgery," " opioid," " pain," " analgesia," and the names of each adjuvant. The references of included studies were searched for additional relevant studies. RESULTS: CONCLUSIONS: Although there is a lack of studies specifically focused in the plastic and reconstructive surgery patient population, the existing literature provides information about when the above adjuvants are likely to have the greatest impact.
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Authors | Ying Hui Low, Tong J Gan |
Journal | Plastic and reconstructive surgery
(Plast Reconstr Surg)
Vol. 134
Issue 4 Suppl 2
Pg. 69S-82S
(Oct 2014)
ISSN: 1529-4242 [Electronic] United States |
PMID | 25255009
(Publication Type: Journal Article)
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