Pre-Emptive Analgesia

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Prevention of injury-induced functional alterations in the CNS by pre-emptive analgesia is a fascinating working hypothesis based on substantial scientific evidence. Studies investigating the treatment of pain via drug delivery across the nasal mucosa show an equivalent or superior pain control to intravenous, intramuscular or subcutaneous delivery methods. Several endoscopic ENT procedures have been recently developed with the aim of minimizing surgical invasiveness; they are associated with mild to moderate post-operative Previous studies used fentanyl by aerosol for postoperative analgesia and They concluded that inhaled fentanyl is an effective, safe and convenient method of analgesia which merits further investigation into such areas as mode of action and method of administration6. Similarly, we also found good analgesic effect of fentanyl by instillation via intranasal route in doses of 2mcg/kg without any significant adverse effect. J M Malinovsky et al (1996)7did a study in which during halothane anaesthesia, 32 children, aged 2-9 year, weight 10-30 kg were allocated randomly to receive ketamine 3 mg kg-1 nasally (group IN3) or ketamine 9 mg kg-1 nasally (group IN9); ketamine 9 mg kg-1 rectally (group IR9); or ketamine 3 mg kg-1 …show more content…

huge V et al 11randomized sixteen patients with neuropathic pain of various origins into two treatment groups: (S)-ketamine 0.2mg/kg (group 1); (S)-ketamine 0.4mg/kg (group 2). They concluded that Intranasal administration of low dose (S)-ketamine rapidly induces adequate plasma concentrations of (S)-ketamine and subsequently of its metabolite (S)-norketamine. The time course of analgesia correlated with plasma concentrations. In our study with intranasal ketamine (1.5mg/kg) we observed (mean±S.D) VAS score (2.32±0.47) in postoperative period, which was inferior to fentanyl group but definitely better when compared to control

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