Updates Clinical
Clinical ® PAIN Updates INTERNATIONAL ASSOCIATION FOR THE STUDY OF PAIN® Volume XIII, No.2 June 2005 EDITORIAL BOARD Editor-in-Chief Daniel B. Carr, MD The Challenge of Preemptive Analgesia Internal Medicine, Endocrinology, Anesthesiology USA Advisory Board 1 Elon Eisenberg, MD n 1988, Wall reviewed emerging data showing that analgesia before surgical Neurology I incision or amputation decreased postsurgical pain or reduced the incidence of Israel phantom pain, respectively, and decreased the amount of postoperative analgesic James R. Fricton, DDS, MS Dentistry, Orofacial Pain needed. Wall’s publication may be the first review of “preemptive analgesia,” USA which is defined as intervention preceding surgery for the purpose of preventing Maria Adele Giamberardino, MD or decreasing postsurgical pain by preventing central sensitization. To attain Internal Medicine, Physiology Italy preemptive analgesia, however, several critical principles must be applied suc- Cynthia R. Goh, MB BS, FRCP, PhD cessfully. Failure to apply all of these principles may lead to inadequate postsur- Palliative Medicine Singapore gical analgesia. In addition, in patients with pre-existing pain before surgery, Alejandro R. Jadad, MD, PhD preemptive analgesia is unfeasible because central sensitization has already oc- Anesthesiology, Evidence-Based curred due to presurgical pain. This issue of Pain: Clinical Updates surveys the Medicine and Consumer Issues Canada basis for, and challenges facing, preemptive analgesia and presents a practical Andrzej W. Lipkowski, PhD, DSc method for its successful practice. Neuropharmacology and Peptide Chemistry Poland Central Sensitization and Wind-up Patricia A. McGrath, PhD Psychology, Pediatric Pain Canada In response to nociceptive impulses, c-fos, a gene expressed rapidly in many Mohammad Sharify, MD types of cells in response to various stimuli, is expressed in spinal dorsal horn Family Medicine, Rheumatology and supraspinal neurons.
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