骨科手术中阿片类药物耐受患者的围手术期管理。

Perioperative management of the opioid tolerant patient for orthopedic surgery.

作者信息

Mahathanaruk Marchyarn, Hitt James, de LeonCasasola Oscar A

机构信息

University at Buffalo Department of Anesthesiology, 252 Farber Hall, 3435 Main Street, Buffalo, NY 14214, USA.

University at Buffalo Department of Anesthesiology, 252 Farber Hall, 3435 Main Street, Buffalo, NY 14214, USA; Division of Pain Medicine, Department of Anesthesiology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.

出版信息

Anesthesiol Clin. 2014 Dec;32(4):923-32. doi: 10.1016/j.anclin.2014.08.009. Epub 2014 Nov 25.

DOI:10.1016/j.anclin.2014.08.009

PMID:25453671

Abstract

The prevalence of opioid use in the North America and some countries of the European Union has resulted in an increase in the number of patients who may exhibit opioid tolerance when requiring postoperative pain management. The approach to postoperative pain control in these patients is different from the strategies used in opioid-naïve patients. Better understanding of the cellular mechanisms of opioid tolerance in animals has resulted in the transfer of these concepts from the basic research to the clinical arena. This article presents new developments in opioid tolerance and how this knowledge can be applied to clinical practice.

摘要

北美和欧盟一些国家阿片类药物的使用流行，导致在需要术后疼痛管理时可能出现阿片类药物耐受性的患者数量增加。这些患者的术后疼痛控制方法不同于未使用过阿片类药物的患者所采用的策略。对动物阿片类药物耐受性细胞机制的更好理解，已促使这些概念从基础研究转化到临床领域。本文介绍了阿片类药物耐受性的新进展以及如何将这些知识应用于临床实践。