Askay Shelley Wiechman, Bombardier Charles H, Patterson David R
University of Washington School of Medicine, Department of Rehabilitation Medicine, Harborview Medical Center, 325 Ninth Avenue, Box 359740, Seattle, WA 98104, USA.
Expert Rev Neurother. 2009 Feb;9(2):271-7. doi: 10.1586/14737175.9.2.271.
The proper management of acute pain has been identified as a primary indicator of quality assurance in US trauma centers. Nearly half of all trauma patients are injured while intoxicated and 75% of these patients have chronic alcohol problems. The management of pain caused by injuries in patients with alcohol problems poses unique challenges. Biases exist regarding the crosstolerance effects of ethanol and opioids and the pain thresholds of patients with substance abuse histories. The purpose of this review is to examine some of the factors that inform our decisions of how to manage acute pain in this population and to review the empirical evidence that exists.
在美国创伤中心,急性疼痛的合理管理已被确定为质量保证的主要指标。几乎一半的创伤患者在醉酒时受伤,其中75%的患者有慢性酒精问题。酒精问题患者因受伤引起的疼痛管理带来了独特的挑战。关于乙醇和阿片类药物的交叉耐受性影响以及有药物滥用史患者的疼痛阈值存在偏差。本综述的目的是研究一些影响我们决定如何管理这一人群急性疼痛的因素,并回顾现有的实证证据。