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A Review of Studies on the Use of New Non-Gabapentinoid Anticonvulsants and Muscle Relaxants in the Control of Acute Postoperative Pain
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Sara Jahani Sani   , Habibeh Mashayekhi-Sardoo , Hesamoddin Hosseinjani |
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Abstract: (216 Views) |
Introduction: Postoperative pain management in any type of surgery is an important issue for patients. Pain relief contributes to decreased hospital costs, shorter hospital stays, and elevated patient consent. Correspondingly, in this review article, we assessed the postoperative pain management efficacy of new non-gabapentinoid anticonvulsants and muscle relaxant drugs in pre-clinical and clinical studies.
Search Method: The scientific databases, including PubMed, Embase, Scopus, and Google Scholar, were searched using relevant keywords: surgery, postoperative pain, analgesia, non-gabapentinoid anticonvulsants, and muscle relaxants. Review articles, duplicate publications, and non-relevant articles were excluded.
Results: New anticonvulsants reduce postoperative pain, length of stay at the postoperative anesthesia care unit, and analgesic requirement after surgeries. Their mechanisms include the inhibition of glutamate release, blocking of the N-type calcium channels of afferent neurons, inhibition of supraspinal 5-hydroxytryptamine-3 receptor, and prevention of cyclin-dependent kinase 5-mediated collapsin response mediator protein 2 phosphorylation. Also, muscle relaxants show the same effects by downregulation of the Cacna1a, Cacna1b, and Runt-related transcription factor 1 gene of dorsal root ganglia, inhibition of the release of glutamate, aspartate or substance P from the terminals of primary afferent C and Aδ fibers, expression of Neurokinin 1 receptor in the spinal dorsal horn, agonistic effect on α2-adrenoceptor, and stimulation of acetylcholine release in the spinal cord.
Conclusion: With respect to the concerns regarding opioid abuse, muscle relaxants, and non-gabapentinoid anticonvulsant drugs can be regarded as safe options for postoperative pain control.
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| Keywords: Surgery, Postoperative Pain, Analgesia, Anticonvulsants, Muscle Relaxants |
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Full-Text [PDF 326 kb]
(34 Downloads)
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Type of Study: Research |
Subject:
General
Received: 2024/02/26 | Accepted: 2023/08/10 | Published: 2023/08/10
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