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急性疼痛的药物治疗:对实践的启示

Pharmacotherapy for acute pain: implications for practice.

作者信息

Krenzischek Dina A, Dunwoody Colleen J, Polomano Rosemary C, Rathmell James P

机构信息

Same-Day Prep/Post-Anesthesia Care Unit, Department of Anesthesia & Critical Care, Department of Surgical Nursing, Johns Hopkins Hospital, Baltimore, Maryland, USA.

出版信息

Pain Manag Nurs. 2008 Mar;9(1 Suppl):S22-32. doi: 10.1016/j.pmn.2007.11.003.

Abstract

Effective treatment of perioperative acute pain requires that information about the patient's goals for pain relief, previous history with analgesics, and type of surgical procedure is used to guide decisions about analgesic regimens. Analgesics are selected based on the location of surgery, degree of anticipated pain, and patient characteristics (such as comorbidities), and routes of administration and dosing schedules are determined to maximize the effectiveness and safety of analgesia while minimizing the potential for adverse events. Pain management therapy is then extended into the postsurgical phase of recovery. To accomplish this, nurses must have a thorough understanding of the pharmacology of analgesics. This article provides useful information for commonly used analgesics, primarily nonsteroidal antiinflammatory drugs (NSAIDs), opioids, and local anesthetics for control of acute postoperative pain.

摘要

围手术期急性疼痛的有效治疗需要依据患者的疼痛缓解目标、既往镇痛药物使用史以及手术类型等信息来指导镇痛方案的决策。根据手术部位、预期疼痛程度和患者特征(如合并症)选择镇痛药,并确定给药途径和给药时间表,以在将不良事件的可能性降至最低的同时,最大限度地提高镇痛效果和安全性。疼痛管理治疗随后会延伸至术后恢复阶段。要做到这一点,护士必须全面了解镇痛药的药理学知识。本文提供了有关常用镇痛药的有用信息,主要是用于控制术后急性疼痛的非甾体抗炎药(NSAIDs)、阿片类药物和局部麻醉药。

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