McDonnell N J, Keating M L, Muchatuta N A, Pavy T J G, Paech M J
Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia.
Anaesth Intensive Care. 2009 Jul;37(4):539-51. doi: 10.1177/0310057X0903700418.
As the number of women giving birth by caesarean increases throughout most of the developed world, so too is research into postoperative pain relief for these women. Like most other post-surgical populations, the new mother needs effective pain relief so that she can mobilise early but she also has the added responsibility of needing to care for her newborn baby. There is no 'gold standard' for post-caesarean pain management; the number of options is large and the choice of method is at least partly determined by drug availability, regional and individual preferences, resource limitations and financial considerations. Most methods rely on opioids, supplemented with anti-inflammatory analgesics, nerve blocks or other adjunctive techniques. The aim of this review is to detail commonly used opioid-based methods and to review the evidence supporting non-opioid methods, when incorporated into a multimodal approach to post-caesarean pain management. Areas of promising research are also discussed.
在大多数发达国家，剖宫产分娩的女性数量不断增加，针对这些女性术后疼痛缓解的研究也在增多。和大多数其他术后人群一样，新妈妈需要有效的疼痛缓解，以便她能尽早活动，但她还额外肩负着照顾新生婴儿的责任。剖宫产术后疼痛管理没有“金标准”；选择众多，方法的选择至少部分取决于药物供应、地区和个人偏好、资源限制以及经济考量。大多数方法依赖阿片类药物，并辅以抗炎镇痛药、神经阻滞或其他辅助技术。本综述的目的是详细介绍常用的基于阿片类药物的方法，并回顾在多模式剖宫产术后疼痛管理方法中纳入非阿片类药物方法的支持证据。还讨论了有前景的研究领域。
