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腹股沟疝修补术后的疼痛控制:当前观点

Pain control following inguinal herniorrhaphy: current perspectives.

作者信息

Bjurstrom Martin F, Nicol Andrea L, Amid Parviz K, Chen David C

机构信息

Department of Anesthesiology, UCLA, Los Angeles, CA, USA.

Department of Anesthesiology, University of Kansas, Kansas City, KS, USA.

出版信息

J Pain Res. 2014 May 29;7:277-90. doi: 10.2147/JPR.S47005. eCollection 2014.

Abstract

Inguinal hernia repair is one of the most common surgeries performed worldwide. With the success of modern hernia repair techniques, recurrence rates have significantly declined, with a lower incidence than the development of chronic postherniorrhaphy inguinal pain (CPIP). The avoidance of CPIP is arguably the most important clinical outcome and has the greatest impact on patient satisfaction, health care utilization, societal cost, and quality of life. The etiology of CPIP is multifactorial, with overlapping neuropathic and nociceptive components contributing to this complex syndrome. Treatment is often challenging, and no definitive treatment algorithm exists. Multidisciplinary management of this complex problem improves outcomes, as treatment must be individualized. Current medical, pharmacologic, interventional, and surgical management strategies are reviewed.

摘要

腹股沟疝修补术是全球范围内最常见的外科手术之一。随着现代疝修补技术的成功应用,复发率已显著下降,其发生率低于慢性疝修补术后腹股沟疼痛(CPIP)的发生率。避免CPIP可以说是最重要的临床结果,对患者满意度、医疗保健利用、社会成本和生活质量的影响最大。CPIP的病因是多因素的,神经性和伤害感受性成分相互重叠,共同导致了这种复杂的综合征。治疗通常具有挑战性,且不存在明确的治疗方案。对这个复杂问题进行多学科管理可改善治疗效果,因为治疗必须个体化。本文综述了当前的医学、药物、介入和手术管理策略。

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