Nossaman Vaughn E, Ramadhyani Usha, Kadowitz Philip J, Nossaman Bobby D
Department of Pharmacology, Tulane University Medical Center, 1430 Tulane Avenue, New Orleans, LA 70129, USA.
Anesthesiol Clin. 2010 Dec;28(4):647-66. doi: 10.1016/j.anclin.2010.08.009.
Recovery from ambulatory surgical procedures can be limited by postoperative pain. Inadequate analgesia may delay or prevent patient discharge and can result in readmission. More frequently, postoperative pain produces discomfort and interrupts sleep, contributing to postoperative fatigue. The development of effective analgesic regimens for the management of postoperative pain is a priority especially in patients with impaired cardiorespiratory, hepatic, or renal function. Tramadol and tapentadol hydrochloride are novel in that their analgesic actions occur at multiple sites. Both agents are reported to be mu-opioid receptor agonists and monoamine-reuptake inhibitors. In contrast to pure opioid agonists, both drugs are believed to have lower risks of respiratory depression, tolerance, and dependence. The Food and Drug Administration has approved both drugs for the treatment of moderate-to-severe acute pain in adults. This article provides an evidence-based account of the role of tramadol and tapentadol in modern clinical practice.
门诊手术的恢复可能会受到术后疼痛的限制。镇痛不足可能会延迟或阻碍患者出院，并可能导致再次入院。更常见的是，术后疼痛会引起不适并干扰睡眠，导致术后疲劳。制定有效的镇痛方案来管理术后疼痛是当务之急，尤其是对于心肺、肝脏或肾功能受损的患者。曲马多和盐酸他喷他多具有创新性，因为它们的镇痛作用发生在多个部位。据报道，这两种药物都是μ-阿片受体激动剂和单胺再摄取抑制剂。与纯阿片类激动剂相比，这两种药物被认为呼吸抑制、耐受性和依赖性的风险较低。美国食品药品监督管理局已批准这两种药物用于治疗成人中度至重度急性疼痛。本文基于证据阐述了曲马多和他喷他多在现代临床实践中的作用。
