[The role of multimodal analgesia in the decrease of postoperative surgical stress response in major neoplastic thoraco-abdominal surgery].
A major issue of the surgical anesthetic team is the surgical stress response, with its organ disfunctions, and the postoperative pain with consequences regarding the physiopathologic and socio-economical impact associated with its inadequate therapy. According to the "fast-track" approach, multimodal analgesia has a central place, together with minimal invasive procedures. Opioid-local anesthetic association via thoracic epidural catheter, has become the "anesthetic golden standard", in major thoraco-abdominal surgery. Co-administration of i.v. non-steroid anti-inflammatory drugs, seriously decreases the inflammatory response to the surgical stress, allowing a faster recovery, an early social rehabilitation, and a decrease in morbidity and mortality associated with major neoplasic surgery.
Clinica ATI, Spitalul Clinic de Urgenţă "Floreasca", Bucureşti, Romania. danapavelescu@hotmail.com
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Păduraru
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Chiotoroiu
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Grinţescu
D000008:Abdominal Neoplasms / Q000601:surgery*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000767:Anesthesia, Epidural; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D011788:Quality of Life; D013312:Stress, Physiological / Q000187:drug effects; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D013899:Thoracic Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal