Citation Information :
Vasan S, Navyashree K, Sowmya M, Sahajananda H. Efficacy of Multimodal Analgesia vs Unimodal Analgesia for Acute Postoperative Pain Relief after Abdominal Surgeries. J Med Sci 2021; 7 (1):5-10.
Background: Pain has a multifactorial origin; therefore, it may be difficult to achieve pain management with a single drug. Hence, multimodal analgesia was introduced. Multimodal analgesia is achieved by combining different analgesics that act by different mechanisms and at different sites in the nervous system, resulting in additive or synergistic analgesics with lowered adverse effects of sole administration of individual analgesics. This is advantageous as it acts by both peripheral and central pain pathways; this minimizes pain with better tolerability and reduces recovery time. The multimodal strategy allows early mobilization, early enteral nutrition, and attenuation of the perioperative stress response which leads to reduced morbidity and accelerated convalescence.
Materials and methods: After institutional ethical committee approval, 60 patients undergoing abdominal surgeries and laparotomies belonging to the American Society of Anesthesiologists (ASA) I and II of either sex, aged between 20 years and 70 years were enrolled for this study. Thirty were provided unimodal analgesia with inj. tramadol and the other 30 received multimodal analgesia with quadratus lumborum block (QLB), inj. tramadol, and inj. diclofenac for postoperative analgesia. Our main aim was to assess the efficacy of multimodal analgesia vs unimodal analgesia for postoperative pain management.
Results: We observed the visual analog scale (VAS) pain scores in patients of both groups at 0, 2, 4, 8, and 12 hours. When the scores were above 7, rescue analgesia with inj. fentanyl was provided. The duration of the first analgesic request and the total number of rescue analgesics given were recorded along with any complications.
Conclusion: Multimodal analgesia was superior compared with the unimodal approach as it provided better analgesia with low VAS score values. Duration of analgesia was longer based on time of request of first rescue analgesia, with reduced adverse effects. It reduced the number of rescue analgesics required and the opioid side effects were overcome by non-steroidal anti-inflammatory drug (NSAID) use.
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