Abad-Gurumeta A, Ripollés-Melchor J, Casans-Francés R, Calvo-Vecino J M
Servicio de Anestesiología y Reanimación, Hospital Universitario Infanta Leonor, Madrid, España.
Servicio de Anestesiología y Reanimación, Hospital Universitario Infanta Leonor, Madrid, España.
Rev Esp Anestesiol Reanim. 2017 Aug-Sep;64(7):406-414. doi: 10.1016/j.redar.2017.01.009. Epub 2017 Mar 22.
There are currently various projects underway that attempt to monitor the nociceptive responses caused by surgical stress and ensure patients the best analgesic conditions. The systemic response to surgical stress has repercussions in the postoperative period, such as worse pain control, delayed recovery, greater complications, longer stay in resuscitation and hospital units, and increased healthcare costs. However, treatment with higher doses of opioids than necessary may lead to slower awakening, increased drowsiness and adverse effects, as well as situations of postoperative opioid-induced hyperalgesia. There are 2 large groups of nociceptive monitoring according to the origin of the theoretical objective of monitoring response to the stimulus, that may derive from changes in the electroencephalogram or the response of the autonomic nervous system.
目前有多个项目正在进行，旨在监测手术应激引起的伤害性反应，并确保为患者提供最佳的镇痛条件。对手术应激的全身反应在术后会产生影响，如疼痛控制不佳、恢复延迟、并发症增多、在复苏室和病房的停留时间延长以及医疗费用增加。然而，使用比必要剂量更高的阿片类药物进行治疗可能会导致苏醒缓慢、嗜睡和不良反应增加，以及术后阿片类药物诱导的痛觉过敏情况。根据监测对刺激反应的理论目标的来源，有两大类伤害性监测，这可能源于脑电图的变化或自主神经系统的反应。
