From the Guidelines
Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are the recommended analgesics for postoperative pain management after suture or wound closure.
Key Points
- The basic analgesic regimen should include paracetamol and NSAIDs administered pre-operatively or intra-operatively and continued postoperatively 1.
- Opioids should be reserved as rescue analgesics in the postoperative period 1.
- Other analgesic options such as gabapentinoids, ketamine, and dexmedetomidine may be considered in specific cases or patient populations 1.
- Regional analgesic techniques, such as local wound infiltration or nerve blocks, may also be used to manage postoperative pain 1.
Important Considerations
- The choice of analgesic should be individualized based on the patient's medical history, surgical procedure, and other factors.
- The use of intravenous dexamethasone may be beneficial for its analgesic and anti-emetic effects 1.
From the Research
Analgesics Used After Suture
- Ropivacaine (ROP) is a well-known analgesic that can be encapsulated in polycaprolactone (PCL) microfibers for sutures, providing long-lasting analgesia capabilities 2
- Lidocaine aerosol has been shown to induce significant analgesia at rest and reduce postoperative requirements of opiate analgesics, such as buprenorphine, during the first 24 hours after surgery 3
- Bupivacaine is a local anesthetic that can be loaded into electrospun poly(lactic-co-glycolic acid) (PLGA) sutures, providing local analgesia for approximately 1 week after surgery 4
- Morphine is an opiate analgesic that may be used for pain management during hospitalization and postpartum, although its use may not differ significantly between suture and staple skin closure groups 5
Suture Materials and Analgesia
- Absorbable polyglactin and nonabsorbable polypropylene suture materials have been compared, with no significant difference found in terms of postoperative pain or need for additional analgesic use 6
- Electrospun drug-eluting sutures, such as those loaded with bupivacaine, may enhance perioperative analgesia and mitigate the need for standard postoperative opioid analgesics 4