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[围手术期疼痛治疗]

[Perioperative pain therapy].

作者信息

Schwenk W, Schinkel B

机构信息

Allgemein- und Viszeralchirurgie, Asklepios Klinik Altona, Hamburg, Deutschland.

出版信息

Chirurg. 2011 Jun;82(6):539-54; quiz 555-6. doi: 10.1007/s00104-010-2051-y.

Abstract

Scientific studies have proven without doubt that an optimized perioperative pain therapy will improve patient comfort, reduce postoperative complications, enhance postoperative recovery and shorten the length of postoperative hospital stay. It is necessary to incorporate the acute pain therapy into a perioperative multimodal and interdisciplinary therapeutic concept. Local or regional anesthesia will provide the best analgesic effect after surgery and should be considered in all patients. Optimal treatment of patients with peripheral nerve blocks, spinal or epidural analgesia should be treated by a specialized acute pain service. However, only 15-20% of all surgical cases will be taken care of by such a pain service. Therefore, most surgical patients will only receive adequate analgesia if surgeons are familiar with the principles of postoperative pain therapy. Regular assessment of pain perception is the cornerstone of optimized pain therapy. Furthermore, pain assessment will allow the administration and to some extent dosage of analgesic therapy to be delegated to nursing personnel.

摘要

科学研究毫无疑问地证明,优化的围手术期疼痛治疗将提高患者舒适度、减少术后并发症、促进术后恢复并缩短术后住院时间。有必要将急性疼痛治疗纳入围手术期多模式和跨学科治疗理念。局部或区域麻醉将在术后提供最佳镇痛效果,所有患者均应考虑采用。外周神经阻滞、脊髓或硬膜外镇痛患者的最佳治疗应由专业的急性疼痛服务团队进行。然而,所有手术病例中只有15%至20%会由这样的疼痛服务团队处理。因此,大多数手术患者只有在外科医生熟悉术后疼痛治疗原则时才能获得充分的镇痛。定期评估疼痛感知是优化疼痛治疗的基石。此外,疼痛评估将使镇痛治疗的给药以及在一定程度上剂量的确定能够委托给护理人员。

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