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脊柱大手术的镇痛治疗

Analgesic therapy for major spine surgery.

作者信息

Puvanesarajah Varun, Liauw Jason A, Lo Sheng-fu, Lina Ioan A, Witham Timothy F, Gottschalk Allan

机构信息

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Neurosurg Rev. 2015 Jul;38(3):407-18; discussion 419. doi: 10.1007/s10143-015-0605-7. Epub 2015 Feb 14.

Abstract

Pain following spine surgery is often difficult to control and can persist. Reduction of this pain requires a multidisciplinary approach that depends on contributions of both surgeons and anesthesiologists. The spine surgeon's role involves limiting manipulation of structures contributing to pain sensation in the spine, which requires an in-depth understanding of the specific anatomic etiologies of pain originating along the spinal axis. Anesthesiologists, on the other hand, must focus on preemptive, multimodal analgesic treatment regimens. In this review, we first discuss anatomic sources of pain within the spine, before delving into a specific literature-supported pain management protocol intended for use with spinal surgery.

摘要

脊柱手术后的疼痛往往难以控制且可能持续存在。减轻这种疼痛需要采取多学科方法,这依赖于外科医生和麻醉医生的共同努力。脊柱外科医生的职责包括尽量减少对导致脊柱疼痛感觉的结构的操作,这需要深入了解沿脊柱轴产生疼痛的具体解剖学病因。另一方面,麻醉医生必须专注于预防性的多模式镇痛治疗方案。在这篇综述中,我们首先讨论脊柱内疼痛的解剖学来源,然后深入探讨一种有文献支持的、适用于脊柱手术的特定疼痛管理方案。

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