The Characteristics of Centrally Acting Non-opioid Analgesics in the Management of Acute Pain and Neuropathic Pain Syndromes.

Treatment of acute pain primarily aims to provide effective analgesia with negligible untoward effects while preventing the development of chronic pain. Opioid-sparing analgesic techniques can reduce the risk of numerous adverse effects, including postoperative nausea and vomiting, dependency, histamine release, hypotension, and respiratory depression. As rich literature data indicate the hazards of opioids, the medical community has long been searching for opioid-sparing analgesic techniques that may alleviate these untoward outcomes. Centrally acting non-opioid analgesics (CANOAs) were launched as alternative agents to opioids. CANOAs modulate pain perception at the central level without interacting with opioid receptors, making them particularly valuable in multimodal analgesia strategies. CANOAs generally have a rapid onset and sustained duration of action. Their unique mechanisms of action enable them to alleviate both nociceptive and neuropathic pain components. Clinicians should consider the specific characteristics, indications, and drawbacks of each agent in different clinical situations. Most professional organizations have issued algorithms and guidelines to guide clinicians on the uses, limitations, and drawbacks of these agents. Although CANOAs may be used as effective agents in pain treatment in various clinical settings, more population-based, controlled studies will further enlighten their role in the evolving management of pain.