MEDICATION AND REGULATION OF ACUTE POSTOPERATORY PAIN, USING MULTIMODAL THERAPY

Abstract

Surgical interventions and opioid exposure activate both peripheral (satellite glial cells) and central glia (microglia and astrocytes), contributing to peripheral and central sensitization and maintenance of pain. Specific molecules such as MMP-9 and IL-1β are involved. Materials and methods: We analyzed female patients who presented for emergency or elective abdominal surgery at the “Cuza-Voda” Hospital of Obstetrics and Gynecology Iași, Romania and who met the following inclusion criteria and did not present any of the exclusion criteria were included in the analysis. Inclusion criteria: Age over 18 years; Surgical obstetrical or gynecological indication. exclusion criteria: patients under 18 years of age; people with suspected sepsis or serious medical comorbidities such as heart failure, undiagnosed fever and instable state. The study was retrospective and prospective, during January 2024 to November 2025, starting from the clinical parameters, surgery indication, analyzing clinically and paraclinically, the importance of intra- and post-operative analgesic medication that was used. Results: Of the total study group, 52.3% of patients underwent cesarean sections (CST), 14.4% underwent total hysterectomy with bilateral adnexectomy (HT+AB) and 9% underwent biopsy curettage, the rest of gynecological surgeries consisted of Madden mastectomy, salpingectomy, ovarian cyst removal. Multimodal drug therapy and opioid treatments were required to achieve the control of post operatory pain. Conclusions: Current areas of interest in pain research include investigating the effect of mood on pain processing in the brain and the search for new drugs to block the channels involved in pain transmission, and the actual important post operatory pain therapy involves a combination of multimodal and opioid treatments.