aDepartment of Anesthesia, General Intensive Care and Pain control at Vienna General Hospital, Medical University of Vienna, Vienna, Austria bDepartment of Anesthesia, University Children's Hospital, Zurich, Switzerland cDepartment of Anesthesiology and Intensive Care Medicine, Cnopf Children's Hospital, Hospital Hallerwiese, Nuernberg, Germany.
Curr Opin Anaesthesiol. 2014 Jun;27(3):316-22. doi: 10.1097/ACO.0000000000000074.
This review highlights the current trends of efficient and safe perioperative pediatric pain therapy in the context of a multimodal pain therapy concept.
A multimodal pain therapy concept should be easy to apply and safe regarding the occurrence of side-effects. The administration of nonopioid analgesics should be obligatory, regional anesthesia techniques - under ultrasound guidance - should be performed whenever possible, opioids should be given immediately and sufficiently whenever necessary, the administration of co-analgesics like lidocaine, dexamethasone or ketamine should be considered, and most importantly, each pain therapy should be performed according to pain assessment and long enough until adequate pain relief.
Safe and simple pediatric pain management in the perioperative period combines not only easy to apply and safe stepwise pain therapy itself, but also adequate pain assessment and the implementation of continuous hospital quality improvement strategies.
本综述强调了在多模式疼痛治疗概念的背景下，高效和安全的围手术期儿科疼痛治疗的当前趋势。
多模式疼痛治疗概念应该易于应用，并且在发生副作用方面是安全的。非阿片类镇痛药的给予应该是强制性的，区域麻醉技术 - 在超声引导下 - 应尽可能进行，在必要时应立即给予足够的阿片类药物，应考虑给予辅助镇痛药，如利多卡因、地塞米松或氯胺酮，最重要的是，每次疼痛治疗都应根据疼痛评估进行，并持续足够长的时间，直到疼痛得到充分缓解。
围手术期安全简单的儿科疼痛管理不仅结合了易于应用和安全的逐步疼痛治疗本身，还包括充分的疼痛评估和实施持续的医院质量改进策略。
