Acute Pain Management

Acute pain is a crucial condition that should be treated quickly as it is responsible for severe consequences andincreases the perioperative complication, morbidity and mortality. Central sensitization, stress response andreflex response are the most known devastating consequences of pain where will be reviewed in this article.Stress response is a lifesaving body response during emergency situations like trauma and bleeding via thehypothalamus- pituitary- adrenal axis activation and stress hormones release. On the other hand, if the pain isthe only cause of the axe activation, stress hormones may cause disastrous consequences like hyperglycemia,hypercoagulability, ischemia and edema.Reflex response, another lifesaving body response, when activates inappropriately with undertreated orneglected pain may interfere the phrenic nerve activity and effective coughing leads to the atelectasia andpulmonary complication. Also, spasm can halt wound healing and with decreasing GI motility and ileus, it willinterrupt the recovery and healing.Central sensitization is an important cause of turning a mismanaged acute pain to a chronic one.Multi-drug therapy, proper dose prescription based on the drugs half-life and dose adjustment are the basicroles for a successful pain management. Also, the combination of drug therapy with other modalities likeneuraxial and peripheral blocks, which refers as multimodal analgesia, is highly advised.Opioids are effective pain medications but should be prescribed with cautious and in a brief period of severepain. Combination therapy with other drugs of different classes addresses both neuropathic and nociceptivepain and minimize the opioid tolerance and physical dependency. It cannot be emphasized enough that thepharmacokinetic and pharmacodynamic knowledge of the opioids are crucial for a successful prescription. Thespecial properties of the certain classes of the opioids and the interactions with other drugs should be noticedand reviewed for each patient.