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非阿片类药物最新进展:用于围手术期疼痛管理的静脉或口服镇痛药

An Update on Nonopioids: Intravenous or Oral Analgesics for Perioperative Pain Management.

作者信息

Kaye Alan D, Cornett Elyse M, Helander Erik, Menard Bethany, Hsu Eric, Hart Brendon, Brunk Andrew

机构信息

Department of Anesthesiology, LSU School of Medicine, 1542 Tulane Avenue, New Orleans, LA 70112, USA; Department of Pharmacology, Louisiana State University School of Medicine, Louisiana State University Health Science Center, 1542 Tulane Avenue, New Orleans, LA 70112, USA.

Department of Anesthesiology, LSU School of Medicine, 1501 Kings Highway, Shreveport, LA 71130, USA.

出版信息

Anesthesiol Clin. 2017 Jun;35(2):e55-e71. doi: 10.1016/j.anclin.2017.01.006. Epub 2017 Mar 30.

Abstract

Despite an appreciation for many unwanted physiologic effects from inadequate postoperative pain relief, moderate to severe postoperative pain remains commonplace. Although treatment options have evolved in recent years, the use of nonopioid analgesics agents can reduce acute pain-associated morbidity and mortality. This review focuses on the importance of effective postoperative nonopioid analgesic agents, such as acetaminophen, nonsteroidal anti-inflammatory agents, gabapentinoid agents, NMDA antagonists, alpha 2 agonists, and steroids, in opioid sparing and enhancing recovery. A careful literature review focusing on these treatment options, potential benefits, and side effects associated with these strategies is emphasized in this review.

摘要

尽管人们认识到术后疼痛缓解不足会带来许多不良生理影响,但中度至重度术后疼痛仍然很常见。尽管近年来治疗选择有所发展,但使用非阿片类镇痛药可以降低与急性疼痛相关的发病率和死亡率。本综述重点关注有效术后非阿片类镇痛药的重要性,如对乙酰氨基酚、非甾体抗炎药、加巴喷丁类药物、NMDA拮抗剂、α2激动剂和类固醇,它们在减少阿片类药物使用和促进恢复方面的作用。本综述强调了对这些治疗选择、潜在益处以及与这些策略相关的副作用进行仔细的文献综述。

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