Elmore Brett, Nguyen Van, Blank Randall, Yount Kenan, Lau Christine
Division of Thoracic & Cardiovascular Surgery, Department of Anesthesia, University of Virginia, Charlottesville, VA 22908, USA.
Division of Thoracic & Cardiovascular Surgery, Department of Anesthesia, University of Virginia, Charlottesville, VA 22908, USA.
Thorac Surg Clin. 2015 Nov;25(4):393-409. doi: 10.1016/j.thorsurg.2015.07.005.
Postoperative pain following thoracic surgery presents a significant challenge, and multiple factors complicate recovery and pain management for this population. Considerable comorbidities often exist in thoracic surgical patients, further limiting therapeutic options. Elements of nociceptive and neuropathic pain may contribute greatly to patient discomfort. There is no single pharmaceutical agent or route of administration that addresses every individual contributor to pain, and thus treatment regimens should be multimodal and tailored to the patient and procedure. This article outlines systemic agents, regional techniques and attendant complications, etiologies of pain following thoracic procedures, and the development and treatment of chronic pain.
胸外科手术后的疼痛是一项重大挑战,多种因素使该人群的恢复和疼痛管理变得复杂。胸外科手术患者通常存在相当多的合并症,这进一步限制了治疗选择。伤害性疼痛和神经性疼痛的因素可能极大地导致患者不适。没有单一的药物或给药途径能解决导致疼痛的每一个因素,因此治疗方案应是多模式的,并根据患者和手术进行定制。本文概述了全身用药、区域技术及相关并发症、胸科手术后疼痛的病因以及慢性疼痛的发生和治疗。