Managing Postoperative Pain After Minimally Invasive Gynecologic Surgery in the Era of the Opioid Epidemic
| Autor: | Karen Wang, K Simpson, S.N. Morris, Marron Wong |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
030219 obstetrics & reproductive medicine business.industry MEDLINE Obstetrics and Gynecology Multimodal therapy Off-label use medicine.disease law.invention Acetaminophen Surgery 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Opioid Pneumoperitoneum law Medicine Local anesthesia 030212 general & internal medicine business medicine.drug |
| Zdroj: | Journal of Minimally Invasive Gynecology. 25:1165-1178 |
| ISSN: | 1553-4650 |
| DOI: | 10.1016/j.jmig.2017.09.016 |
| Popis: | In this review, we examine the evidence behind nonopioid medication alternatives, peripheral nerve blocks, surgical techniques, and postoperative recovery protocols that can help minimize and effectively treat postoperative pain after minimally invasive gynecologic surgery (MIGS). Because of the depth and heterogeneity of the data, a narrative review was performed of reported interventions. A comprehensive review was performed of PubMed, Embase, and the Cochrane Database with a focus on randomized controlled trials. In the absence of literature specific to benign gynecology, similar specialty or procedural data were reviewed. A variety of nonopioid medications, surgical techniques, and postoperative recovery protocols have shown significant improvements in postoperative pain after gynecologic surgery. Nonopioid medication options that are beneficial include acetaminophen, nonsteroidal anti-inflammatories, and antiepileptics. Incision infiltration with local anesthesia also significantly reduces pain. Surgically, minimally invasive approaches, reducing the laparoscopic trocar size to |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|