Supervisors info:
Κωνσταντίνος Μπίρμπας, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Ιωάννης Κακλαμάνος, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Θεόδωρος Μαριόλης - Σαψάκος, Αναπληρωτής Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Introduction: Pain is defined as "An unpleasant aesthetic and emotional experience associated with, or similar to, associated with actual or potential tissue damage," according to the revised definition of the International Association for the Study of Pain (IASP). Acute postoperative pain differs from chronic pain, is of high intensity and is a condition that requires immediate resolution. As an alternative solution to the use of opioids, where their overdose is a current phenomenon and causes a multitude of side effects or even leads to addiction, is the administration of non-opioid drugs either exclusively or in combination with a small number of opioids.
Aim: The purpose of this systematic review is to investigate whether the postoperative analgesia of patients after general, thoracic, orthopedic, or neurosurgical procedures with non-opioid analgesics is as effective as analgesia with opioid drugs. Through this, it becomes possible to investigate whether this method can limit the use of opioid substances postoperatively.
Methodology: For the systematic review, the existing literature was searched in the PubMed database using keywords. Through selection and exclusion criteria, the sample of the review consisted of 20 articles.
Results: The non-opioid drugs used gave the patients a similar and high analgesic effect compared to the opioid drugs, with a generally low pain score. All patients showed high satisfaction in dealing with post-operative pain and in their general post-operative experience. The side effects that occurred were few and mild in intensity, fewer than in people who received higher doses of opioid analgesics. Finally, the recovery time of the patients was the same, without difficulty or prolongation.
Conclusions: In conclusion, we find that non-opioid drugs are substances effective against acute postoperative pain, especially when they belong to a multimodal analgesia regimen with co-administration of non-opioid drugs and small doses of opioids. At the same time, they show a small number of side effects, of mild intensity that can be treated easily. Patients with this mode of analgesia require smaller and fewer rescue doses. Through these, it is established that multimodal analgesia with doses of non-opioid drugs limits to a considerable extent the consumption of opioid substances, thus simultaneously limiting side effects and, in the worst cases, dependence and addiction to opioids.
