الفهرس 
ANATOMICAL CONSIDRATIONOnly 14 pages are availabe for public view
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Abstract
Postoperative pain is an acute pain starts with surgical trauma and usually ends with tissue healing. Relief of postoperative pain after abdominal and orthopaeclic surgery was provided traditionally by parentral opioid analgesics or local anaesthetic regimens.
Acute postoperative pain services are being increasingly established to provide good quality of postoperative analgesia and a potential reduction in postoperative complications associated with pain and immobility and the potential to reduce long term pain syndromes However the major argument remain a humanitorian one-the relief of suffering.
Tissue injury leads to release of substance P from nerve ending and release of algogenic substances (bradykinin, serotonin, histamin and arachidonic cascade metabolites) resulting in vasodiltation, increase vascular permeability and sensitization of nociceptors.
Secondary hyperalgesia results probably from functional changes in both the peripheral and central nervous system. Arachidonic acid can be metabolized to the prostaglandin endoperoxides (pg E) by the enzyme cyclo-oxygenase or to hydroxy-peroxy-derivatives (HPETE) and leucotrienes by the lipo-oxygenase pathway, NSAIDs inhibit the biosynthesis of prostaglandins by means of an acetylation and consequent inactivation of cyclo-oxygenase so the endocrine, metabolic.