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Optimal Drug Combinations In Post-operative Pain Management: A Modified Direct-Search Approach


V. Sartori

vol. AUT06-02

Continuous epidural administration of analgesics is a widely used method for the treatment of postoperative pain [6]. Di erent drugs are variously combined to maximize analgesia and minimize side e ects, such as motor block, hypotension, sedation, nausea, vomiting, pru- ritus, and respiratory depression. One reason for using drug combinations is the expected enhancement of the analgesic e ect as a result of the action of the di erent drugs on di erent pain mechanisms [4, 7, 8, 11, 12]. An additive or supra-additive interaction may allow the achievement of an e ect that would not be obtained by using single drugs [9]. A basic problem in investigating drug combinations and, in general, therapy regimens is the number of possible combinations. In clinical practice, at least two or three drugs are combined. For example, if ve di erent combinations for three drugs are considered, 53 = 125 di erent combinations exist. Clearly, it is impossible to analyze all possible combinations by randomized controlled trials. The choice of the combinations that are compared in such trials is mostly made arbitrarily. As a result, the chosen combinations might be far away from the region of the optimal combinations. The aim of this work is to develop and apply a black-box search algorithm to eciently optimize the combination of drugs to be epidurally administered in post-operative pain management, in a way of maximizing the pain relief while minimizing the occurrence of side e ects for the patients.


Type of Publication:

(04)Technical Report

M. Morari

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% Autogenerated BibTeX entry
@TechReport { Xxx:2006:IFA_2421,
    author={V. Sartori},
    title={{Optimal Drug Combinations In Post-operative Pain
	  Management: A Modified Direct-Search Approach}},
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