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Table 2 Treatment of postoperative pain

From: Postoperative pain pathophysiology and treatment strategies after CRS + HIPEC for peritoneal cancer

Analgesic

 Acetaminophen, NSAIDs, COX-2 inhibitor [59], gabapentin [60]

There was no alleviation of perioperative inflammation with the preoperative administration of celecoxib, tramadol and pregabalin, and intraoperative TIVA combined with propofol, dexmedetomidine, ketamine, and lidocaine [61].

 Propofol [62], dexmedetomidine [63], ketamine [64, 65], and lidocaine [66] have independent anti-inflammatory properties.

 Calcium channel α-2-δ ligand anticonvulsant drugs, tricyclic antidepressants, selective 5-HT, and norepinephrine reuptake inhibitors

They provide symptomatic reliefs and the effects are often limited.

Regional nerve block

 

 TEA combined with opioids has the advantages of analgesia, early extubation after surgery, lower postoperative pulmonary complications, and reduced incidence of postoperative complications [67,68,69,70]

TEA is a safe option for CRS + HIPEC treatment, regardless of some fluctuations in intraoperative coagulation measurements [71, 72].