ABSTRACT
Preemptive analgesia refers to the application of analgesic techniques before the patient is exposed to noxious stimuli. This decreases the intensity and duration of post-procedure pain and minimizes the likelihood of a chronic pain state being established. Examples of preemptive analgesic techniques include the use of anesthetic premedication such as opioids, alpha2 agonists, and NSAIDs, or the presurgical epidural administration of local anesthetics or opioids. Balanced, or multimodal, analgesia is achieved by the simultaneous administration of two or more analgesic drug classes or techniques. Since various classes of drugs such as NSAIDs, opioids, alpha2 agonists, and local anesthetics have additive or synergistic analgesic effects when co-administered, dosages can typically be reduced. When used preemptively, balanced analgesia helps to prevent or inhibit surgery-induced peripheral nociceptor sensitization and neuroplastic changes within the spinal cord, prevent development of tachyphylaxis, suppress the neuroendocrine stress response to pain and injury, and so on.
