Koepke Elena J, Manning Erin L, Miller Timothy E, Ganesh Arun, Williams David G A, Manning Michael W
1Division of General, Vascular and Transplant Anesthesiology, Department of Anesthesiology, Duke University, Box 3094, 2301 Erwin Road, Durham, NC 27710 USA.
2Division of Regional Anesthesiology, Department of Anesthesiology, Duke University, Durham, USA.
Perioper Med (Lond). 2018 Jul 3;7:16. doi: 10.1186/s13741-018-0097-4. eCollection 2018.
Opioid use has risen dramatically in the past three decades. In the USA, opioid overdose has become a leading cause of unintentional death, surpassing motor vehicle accidents. A patient's first exposure to opioids may be during the perioperative period, a time where anesthesiologists have a significant role in pain management. Almost all patients in the USA receive opioids during a surgical encounter. Opioids have many undesirable side effects, including potential for misuse, or opioid use disorder. Anesthesiologists and surgeons employ several methods to decrease unnecessary opioid use, opioid-related adverse events, and side effects in the perioperative period. Multimodal analgesia, enhanced recovery pathways, and regional anesthesia are key tools as we work towards optimal opioid stewardship and the ideal of effective analgesia without undesirable sequelae.
在过去三十年中，阿片类药物的使用急剧增加。在美国，阿片类药物过量已成为意外死亡的主要原因，超过了机动车事故。患者首次接触阿片类药物可能是在围手术期，此时麻醉医生在疼痛管理中发挥着重要作用。在美国，几乎所有接受手术的患者都会使用阿片类药物。阿片类药物有许多不良副作用，包括潜在的滥用或阿片类药物使用障碍。麻醉医生和外科医生采用多种方法来减少围手术期不必要的阿片类药物使用、与阿片类药物相关的不良事件和副作用。多模式镇痛、加速康复路径和区域麻醉是我们实现最佳阿片类药物管理以及有效镇痛且无不良后遗症这一理想目标的关键工具。
