Post-Operative Pain: Mechanisms and Management

Background: Proper postoperative pain management, which can be advanced using a multimodal approach, results in pain relief with minimal side effects. Newer recovery protocols, along with minimally invasive surgeries add to the better management of post-operative complication. Many factors play a role in failure of proper postoperative pain management, which mainly include insufficient education, fear of complications associated with analgesic drugs, poor pain assessment and inadequate staffing

Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE from January 1987 to March 2017. The following search terms were used: post-operative pain mechanism, post-operative pain management, non-opioid pain management

Aim of the work: In this study we aimed to understand the mechanism and the management of post-operative pain, along with shining some light upon the recent advances

Conclusion: Various combinations and modalities of pain management exist, and their use depends largely on the case, the patients, and their perception of pain. Enhanced recovery protocols have significantly improved perioperative and postoperative pain management, making the decrease in opioids need a priority

Etiologies and management of postural tachycardia syndrome in children

Postural tachycardia syndrome [POTS] is a chronic condition with frequent symptoms of orthostatic intolerance or with sympathetic activation and excessive tachycardia while standing, without significant hypotension. The aim of this review was to discuss the pathogenesis and to outline the diagnosis and treatment guidelines. We conducted a literature review of articles published up to 2017, in following databases; PubMed, and Embase investigating postural tachycardia syndrome in children. We restricted our search to only English published articles with human subjects concerning children under 16 years. POTS is a disorder of the autonomic nervous system that could create considerable disability amongst previously healthy people. Patients with POTS show a HR rise of 30 bpm within 10 min of standing [or greater in kids], are typically hyperadrenergic, and tend to have a reduced blood volume. The pathophysiology of POTS is complex and the result of a variety of separate systems producing a common pattern of signs. The specific pathogenesis of POTS has yet not been completely clear. A variety of uncommon factors might be involved in the pathogenesis. Selecting the correct therapy according to the detailed pathogenesis could absolutely enhance the efficiency of medicine. Treatments targeting the hypovolemia and the excess sympathetic nervous system activation may assist eliminate symptoms