Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University, The Johns Hopkins Hospital, Carnegie 280, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Thorac Surg Clin. 2009 Aug;19(3):353-61. doi: 10.1016/j.thorsurg.2009.06.004.
The management of postoperative pain in the elderly represents a considerable challenge because these patients are generally at higher risk for postoperative complications. There are several analgesic options, some of which may influence perioperative morbidity in this high-risk group of patients. Although use of regional analgesia, particularly epidural analgesia is associated with some benefits, including a decrease in perioperative morbidity, there are side effects and complications (eg, medication-related side effects, epidural hematoma, infection) from these and other techniques, and the clinician should evaluate the benefits and risks of each technique on an individual basis. Nevertheless, the available data suggest that use of regional analgesic techniques (ie, epidural and paravertebral catheters) is associated with a decrease in perioperative pulmonary complications.
老年人术后疼痛的管理是一项重大挑战，因为这些患者术后并发症的风险通常更高。有几种镇痛选择，其中一些可能会影响这群高风险患者的围手术期发病率。尽管使用区域镇痛，特别是硬膜外镇痛与一些益处相关，包括降低围手术期发病率，但这些和其他技术也存在副作用和并发症（例如，与药物相关的副作用、硬膜外血肿、感染），临床医生应根据个体情况评估每种技术的益处和风险。尽管如此，现有数据表明，使用区域镇痛技术（即硬膜外和椎旁导管）与降低围手术期肺部并发症相关。
