Kehlet And Dahll Analysis

Kehlet and Dahl first described the concept of combining multiple analgesic techniques in 1993 as a method of improving outcome following colon surgery6.Multimodal analgesia requires an understanding of the molecular mechanisms of pain pathways. Postoperative pain is a consequence of tissue injury, nerve irritation and the resulting cascade of neurohumeral events that follow. After a painful stimulus, chemical mediators such as prostaglandins (PGE2) and bradykinin are released at the site of tissue injury. These chemical mediators stimulate nociceptors, peripheral pain receptors that respond to trauma and high temperatures. These nociceptors form pain fibers that enter the spinal cord via the dorsal root ganglion. Pain receptors that are principally