Department of Anesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, Australia.
Curr Opin Anaesthesiol. 2013 Aug;26(4):420-7. doi: 10.1097/ACO.0b013e3283625cc8.
Poor pain management has continued to be a problem after pediatric surgery. This review examines the current situation and recent advances in the area.
Nonopioids such as paracetamol and NSAIDs play an increasing role as components of multimodal analgesia in children. However, studies on the safety and efficacy of many adjuvants in pediatrics are still lacking. The use of opioids is influenced understandably by safety concerns about respiratory depression, but data on its incidence are poor. The role of regional techniques in the treatment of pain after pediatric surgery is growing in line with the developments in adults; the emphasis here is more on peripheral techniques too.
The concept of multimodal analgesia including the use of regional analgesic techniques is governing the current developments and discussions in the area of pediatric postoperative analgesia.
小儿手术后的疼痛管理仍然存在问题。本篇综述探讨了这一领域的现状和最新进展。
非甾体抗炎药(如对乙酰氨基酚和 NSAIDs)在儿童多模式镇痛中发挥着越来越重要的作用。然而,在儿科中,许多辅助药物的安全性和有效性研究仍然缺乏。由于对呼吸抑制的安全性的担忧,阿片类药物的使用受到了限制,但关于其发生率的数据却很差。区域技术在小儿手术后疼痛治疗中的作用与成人的发展相一致;这里更强调外周技术。
包括使用区域镇痛技术的多模式镇痛概念,主导着小儿术后镇痛领域的当前发展和讨论。