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围手术期疼痛管理的现状:护士面临的挑战与潜在机遇

The Current State of Perioperative Pain Management: Challenges and Potential Opportunities for Nurses.

作者信息

Simpson Melanie H, Bruckenthal Patricia

出版信息

AORN J. 2016 Dec;104(6S):S1-S8. doi: 10.1016/j.aorn.2016.10.014.

Abstract

Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population. Systemic inefficiencies and problematic medical practice patterns can also have negative effects on perioperative pain management. As the surgical patient's primary advocate, perioperative nurses play an important role in overcoming these diverse challenges and addressing the problems associated with inadequately controlled postsurgical pain.

摘要

实现充分的术后疼痛管理是医疗保健中的一项关键挑战,估计四分之三的成年外科手术患者术后报告有中度至重度疼痛。尽管众所周知这类药物经常会产生不良副作用,但急性护理环境中对阿片类药物的过度依赖仍然存在。此外,有慢性阿片类药物使用史的患者在术后疼痛管理方面存在更多挑战。新型镇痛剂和麻醉技术的发展进步可能对有慢性阿片类药物使用史的外科手术患者以及整个外科手术患者群体有用。系统效率低下和有问题的医疗实践模式也会对围手术期疼痛管理产生负面影响。作为手术患者的主要支持者,围手术期护士在克服这些多样的挑战以及解决与术后疼痛控制不足相关的问题方面发挥着重要作用。

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