Beverly Anair, Kaye Alan D, Ljungqvist Olle, Urman Richard D
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Department of Anesthesiology and Pharmacology, Anesthesiology Services, University Medical Center Hospital, LSU School of Medicine T6M5, 1542 Tulane Avenue, Room 656 New Orleans, LA 70112, USA.
Anesthesiol Clin. 2017 Jun;35(2):e115-e143. doi: 10.1016/j.anclin.2017.01.018.
Perioperative multimodal analgesia uses combinations of analgesic medications that act on different sites and pathways in an additive or synergistic manner to achieve pain relief with minimal or no opiate consumption. Although all medications have side effects, opiates have particularly concerning, multisystemic, long-term, and short-term side effects, which increase morbidity and prolong admissions. Enhanced recovery is a systematic process addressing each aspect affecting recovery. This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS). We describe current evidence and important future directions for effective perioperative multimodal analgesia in enhanced recovery pathways.
围手术期多模式镇痛采用多种镇痛药物联合使用，这些药物以相加或协同的方式作用于不同的部位和途径，以在极少使用或不使用阿片类药物的情况下实现疼痛缓解。尽管所有药物都有副作用，但阿片类药物具有特别令人担忧的多系统、长期和短期副作用，这些副作用会增加发病率并延长住院时间。加速康复是一个针对影响康复的各个方面的系统过程。本文概述了形成手术加速康复学会（ERAS）当前多模式镇痛建议的证据基础。我们描述了加速康复途径中有效围手术期多模式镇痛的当前证据和重要的未来方向。
