Kumar Kanupriya, Kirksey Meghan A, Duong Silvia, Wu Christopher L
From the *Department of Anesthesiology, Hospital for Special Surgery, New York; †Herzl Family Medicine Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; and ‡Department of Anesthesiology and Critical Care Medicine, the Johns Hopkins Hospital, Baltimore, Maryland.
Anesth Analg. 2017 Nov;125(5):1749-1760. doi: 10.1213/ANE.0000000000002497.
There is an epidemic of opioid use, abuse, and misuse in the United States, which results in significant morbidity and mortality. It may be difficult to reduce perioperative opioid use given known acute surgical trauma and resultant pain; however, the discrete and often limited nature of postoperative pain also may make management easier in part by utilizing nonopioid modalities, such as regional anesthesia/analgesia, and multimodal analgesia, which may decrease the need for powerful opioids. This article reviews the relevant literature describing the use of adjunct medications, regional anesthesia and analgesic techniques, and regional block additives in the context of providing adequate pain control while lessening opioid use.
美国存在阿片类药物使用、滥用和误用的流行情况，这导致了显著的发病率和死亡率。鉴于已知的急性手术创伤和由此产生的疼痛，减少围手术期阿片类药物的使用可能具有挑战性；然而，术后疼痛的离散性且通常有限的性质，也可能部分地通过使用非阿片类方法（如区域麻醉/镇痛）和多模式镇痛来使管理更容易，这可能会减少对强效阿片类药物的需求。本文回顾了相关文献，这些文献描述了在提供充分疼痛控制同时减少阿片类药物使用的背景下辅助药物、区域麻醉和镇痛技术以及区域阻滞添加剂的使用情况。
