وصف
Rehabilitation techniques for post-surgical recovery are designed to restore function, reduce pain, and prevent complications. The process begins with a personalized assessment, followed by a phased approach that often includes physical therapy, occupational therapy, and patient education.
In the early stages, passive movements and gentle range-of-motion exercises are employed to prevent stiffness and enhance circulation, reducing the risk of blood clots and swelling. As healing progresses, active exercises are introduced to strengthen muscles, improve flexibility, and restore balance and coordination.
ملخص
- Opioids, derived from the opium poppy, have been used for pain relief and anesthesia since ancient times, gaining prominence during World War II. While effective for pain management, they carry risks like respiratory depression, nausea, constipation, and addiction, leading to regulations. Opioids are classified into natural, semi-synthetic, and synthetic types, used in various surgeries and chronic pain management.
- Opioid overdose leads to various complications, affecting nearly every bodily system, from behavioral changes and cardiovascular issues to liver dysfunction and infectious diseases. The Western world faces an opioid epidemic, prompting the discussion of opioid-free analgesia as a means to reduce dependence and improve patient outcomes. The goals are safer analgesics with minimal side effects, enabling early ambulation and patient control.
- Opioid-sparing anesthesia involves multimodal regimens, combining multiple classes of analgesics, and regional anesthesia techniques, enhanced by ultrasound guidance. This approach aims to reduce opioid dosage, prevent addiction, and improve postoperative recovery. The strategy focuses on managing peripheral sensitization with local anesthetics and central sensitization using drugs like propofol and ketamine.
- Baruch Friedberg's concept emphasizes measuring brain stimulus, preempting pain, and eliminating emetogenic drugs. Opioid-free anesthesia is particularly suitable for peripheral surgeries, patients with COPD, geriatric patients, and those with opioid intolerance. Barriers to wider adoption include the lack of opioid crisis in some regions, cost of alternative techniques, and limited data and guidelines.
- At Aster Healthcare, an ERAS pathway called the SPEED knee program was developed for total knee replacement surgeries, eliminating opioid use. Patients experienced ambulation on the day of surgery and pain relief without opioids, demonstrating the potential for clinical practice change. Overcoming barriers requires changes in knowledge, attitude, and behavior, promoting opioid-free anesthesia as an alternative to the traditional opioid-inclusive approach.
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