Pogatzki-Zahn E M, Zahn P K
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Münster, Albert-Schweitzer-Strasse 33, 48149 Münster.
Schmerz. 2008 Jun;22(3):353-67; quiz 368-9. doi: 10.1007/s00482-008-0665-5.
The onset of postoperative pain is the result of various pathophysiological mechanisms and depends on the type of surgery performed. Therefore, any adequate postoperative pain treatment requires multimodal and procedure-specific analgesia. In addition to reducing perioperative complications and improving patient comfort, optimal postoperative pain management also represents an important quality characteristic which can influence the patient in their choice of hospital. In the past 1-2 years, known groups of substances have been rediscovered for postoperative pain therapy (e.g., Gabapentin and Pregabalin, i.v. Lidocaine, Ketamine or glucocorticoids), while new substances (coxibe, oral oxycodone+naloxone) and applications have been developed. The present overview article discusses the advantages and disadvantages of these substances and analgesic methods, as well as their specific areas of application.
术后疼痛的发作是多种病理生理机制的结果,并且取决于所进行的手术类型。因此,任何充分的术后疼痛治疗都需要多模式和针对具体手术的镇痛。除了减少围手术期并发症和提高患者舒适度外,最佳的术后疼痛管理也是一项重要的质量特征,它可能会影响患者对医院的选择。在过去的1至2年中,已知的药物类别已被重新用于术后疼痛治疗(例如,加巴喷丁和普瑞巴林、静脉注射利多卡因、氯胺酮或糖皮质激素),同时还开发了新的药物(昔布类、口服羟考酮+纳洛酮)和应用方法。本文综述讨论了这些药物和镇痛方法的优缺点及其具体应用领域。