Mostafa Somri
Technion Institute of Technology, Israel
Title: Pre-emptive and protective analgesia approaches in pediatric and adult populations
Biography
Biography: Mostafa Somri
Abstract
Surgical trauma produces a stress reflex and the central with peripheral nervous system elicit neuroendocrine response which begins at the onset of the surgery and continues several days post-operative. Pain is involved in a series of neurochemical events collectively known as nociception, consisting of four physiologic processes like transduction, transmission, modulation and perception. Experimental data demonstrated that various anti-nociceptive analgesic techniques applied before injury was more effective in reducing post-injury pain as compared with administration after injury. This approach has been defined as pre-emptive analgesia. It is defined as treatment that starts before surgery and prevents the establishment of central sensitization caused by incisional and inflammatory injuries. It focuses on the timing of administration of analgesic medication or technique, whereas the protective analgesia approach is not time related and may not be initiated before surgery and pain is reduced relative to another treatment or placebo. Post-operative pain management in pediatric and adult populations is a challenge, despite the development of new drugs and techniques. In our studies which are comparing the effect of intravenous paracetamol as pre-emptive to protective analgesia in a pediatric dental setting. The results demonstrated that administration of intravenous paracetamol pre-emptively provided lower pain scores and decreased percentage of children required pain relief and less amount of post-operative opioids compared to protective administration. Another work investigated the effect of preoperative Etoricoxib within a protective multimodal analgesic regimen with respect to pain control following open hernia repair in adults. The conclusion was that preoperative Rofecoxib administration combined with spinal anesthesia is superior to spinal alone in controlling pain after inguinal hernia repair.
Recent Publications
- Somri M, Gaitini L, Matter I, Hawash N, Falcuci O, Garcia Fornari G, Charco Mora P, Swaid F and Vaida S (2018) A comparison between the supreme laryngeal mask airway and the laryngeal tube suction during spontaneous ventilation: a randomized prospective study. Journal of Anesthesiology Clinical Pharmacology 34:182-7.
- Somri M, Hawash N, Hadjittofi C, Sukhotnic I, Sabbah M, Swaid F, Shalash H and Matter I (2018) Post-operative outcomes in the pyloromyotomy procedure under spinal anaesthesia: A retrospective study in 100 cases. Acta Anaesthesiologica Belgica 69:31-37.
- Kharouba J, Hawash N, Peretz B, Blumer S, Srour Y, Nassar M, Sabbah M, Safadi A, Khorev A and Somri M (2018) Effect of intravenous paracetamol as pre-emptive compared to preventive analgesia in a paediatric dental setting: a prospective randomized study. International Journal of Paediatric Dentistry 28:83-91.