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[骨科/创伤外科中的急性疼痛治疗]

[Acute pain therapy in orthopedics/trauma surgery].

作者信息

Rehart S, Henniger M, Arndt M

机构信息

Klinik für Orthopädie und Unfallchirurgie, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Deutschland.

出版信息

Orthopade. 2018 Oct;47(10):883-896. doi: 10.1007/s00132-018-3618-4.

Abstract

The management of acute pain is of utmost importance in the treatment regimen of orthopedic and trauma patients. Pain perception is different for each patient and has to be individually addressed. Especially in a postoperative setting often with a very dynamic course of pain, it is optimal that the pain management is adapted to the individual course of pain. In this situation it makes sense to apply patient-controlled systems. By combining different analgesic substance classes and non-pharmaceutical therapy in the sense of a multimodal concept, the mechanisms of action complement each other and side effects can be reduced. Patient satisfaction is higher when they are actively involved in the (medicinal) pain therapy and in the decision making. This is particularly important for patient-controlled analgesia (PCA). In addition to invasive catheter administration procedures, there are also modern approaches for oral individual self-administered opioid treatment.

摘要

急性疼痛的管理在骨科和创伤患者的治疗方案中至关重要。每个患者的疼痛感知都不同,必须针对个体情况进行处理。特别是在术后环境中,疼痛过程往往非常动态,疼痛管理应根据个体疼痛过程进行调整才是最佳的。在这种情况下,应用患者自控系统是有意义的。通过多模式概念将不同的镇痛药物类别和非药物治疗相结合,作用机制相互补充,副作用可以减少。当患者积极参与(药物)疼痛治疗和决策时,患者满意度会更高。这对于患者自控镇痛(PCA)尤为重要。除了侵入性导管给药程序外,还有现代的口服个体自我给药阿片类药物治疗方法。

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