Schwacha Martin G
Department of Surgery and Pathology, University of Alabama at Birmingham Birmingham, AL 35852, USA.
Int J Clin Exp Med. 2008;1(1):42-9. Epub 2008 Jan 20.
Opiates are the analgesic of choice for the treatment of post-burn, -trauma and -surgical pain, however, it is also well-established that opiates can induce immune complications. These complications, independent of the analgesic regime, are also associated with severe traumatic injuries, such as burns. Recent findings suggest that opiates can contribute to immune and infectious complications in experimental and clinical settings. Based on the immunomodulatory properties of opiate analgesics their therapeutic use/misuse post-injury may contribute to the development of complications leading to increased morbidity and mortality in this patient population. An improved understanding of the relationship(s) between opiates and complications following major injury, such as burn trauma is likely to contribute towards an improvement in existing, as well as the development of new therapeutic regimes. This review will focus on the role of opiate analgesic usage and abuse and in the development of complications following major traumatic injury with a particular emphasis on burn injury.
阿片类药物是治疗烧伤、创伤和手术后疼痛的首选镇痛药，然而，阿片类药物会引发免疫并发症这一点也已得到充分证实。这些并发症与镇痛方案无关，也与严重创伤性损伤（如烧伤）有关。最近的研究结果表明，在实验和临床环境中，阿片类药物会导致免疫和感染并发症。基于阿片类镇痛药的免疫调节特性，其在损伤后的治疗性使用/滥用可能会导致并发症的发生，从而增加该患者群体的发病率和死亡率。更好地理解阿片类药物与重大损伤（如烧伤创伤）后并发症之间的关系，可能有助于改进现有治疗方案以及开发新的治疗方案。本综述将重点关注阿片类镇痛药的使用和滥用在重大创伤性损伤后并发症发生过程中的作用，尤其着重于烧伤损伤。
