*2.2.8 Analgesia*

The importance of perioperative control of pain in MMD cannot be overstated. Pain is associated with neuroendocrine responses, resulting in an increase in cerebral metabolism that is detrimental to MMD. A postoperative cerebral infarction may be associated with inadequate pain control. Therefore, adequate perioperative analgesia may reduce the risk of cerebral ischemia or infarction [40]. Multimodal analgesia (MMA) strategy is often employed to optimize pain control and limit the undesired side effect simultaneously. MMA includes the use of opioids coupled with acetaminophen, gabapentin, or pregabalin, and non-narcotic analgesics such as tramadol and COX-2 inhibitors [52, 53]. The use of local anesthetic and regional anesthesia is also recommended. Patient-controlled analgesia can also be considered in the postoperative period.

*Perioperative Considerations for Revascularization and Non-Revascularization Surgeries… DOI: http://dx.doi.org/10.5772/intechopen.96564*
