Fast Five Quiz: Overview of Acute Pain Management

Shaheen E. Lakhan, MD, PhD, MS, MEd


January 14, 2022

Intravenous administration of ketamine or magnesium, two commonly used NMDA receptor antagonists, has been shown to be beneficial for reducing postoperative pain and opioid consumption and may reduce the incidence of chronic persistent postsurgical pain. Recently, a systematic literature review suggested that intranasal ketamine may be a safe and effective alternative to intravenous opioids for acute pain in the postoperative setting. Randomized controlled trials are expected to further investigate the efficacy, appropriate dose, and appropriate duration of intranasal ketamine for acute postoperative pain.

Routine use of NMDA receptor antagonists is not yet included in most enhanced recovery after surgery (ERAS) pathways; however, they are increasingly recognized as a useful perioperative adjuvant, particularly for opioid-tolerant patients.

Learn more about the management of acute postoperative pain.


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