Zubrzycki Marek, Liebold Andreas, Skrabal Christian, Reinelt Helmut, Ziegler Mechthild, Perdas Ewelina, Zubrzycka Maria
Department of Cardiac Surgery, University of Ulm Medical Center, Ulm, Germany,
Department of Cardiac Anesthesiology, University of Ulm Medical Center, Ulm, Germany.
J Pain Res. 2018 Aug 24;11:1599-1611. doi: 10.2147/JPR.S162067. eCollection 2018.
Analysis of the problem of surgical pain is important in view of the fact that the success of surgical treatment depends largely on proper pain management during the first few days after a cardiosurgical procedure. Postoperative pain is due to intraoperative damage to tissue. It is acute pain of high intensity proportional to the type of procedure. The pain is most intense during the first 24 hours following the surgery and decreases on subsequent days. Its intensity is higher in younger subjects than elderly and obese patients, and preoperative anxiety is also a factor that increases postoperative pain. Ineffective postoperative analgesic therapy may cause several complications that are dangerous to a patient. Inappropriate postoperative pain management may result in chronic pain, immunosuppression, infections, and less effective wound healing. Understanding and better knowledge of physiological disorders and adverse effects resulting from surgical trauma, anesthesia, and extracorporeal circulation, as well as the development of standards for intensive postoperative care units are critical to the improvement of early treatment outcomes and patient comfort.
鉴于心脏外科手术后最初几天的适当疼痛管理在很大程度上决定了手术治疗的成功，对外科手术疼痛问题进行分析很重要。术后疼痛是由于术中组织损伤所致。它是与手术类型成比例的高强度急性疼痛。疼痛在手术后的头24小时最为剧烈，随后几天会减轻。年轻患者的疼痛强度高于老年和肥胖患者，术前焦虑也是增加术后疼痛的一个因素。无效的术后镇痛治疗可能会导致对患者有危险的几种并发症。不适当的术后疼痛管理可能会导致慢性疼痛、免疫抑制、感染以及伤口愈合效果不佳。了解并更好地认识手术创伤、麻醉和体外循环所导致的生理紊乱和不良反应，以及制定重症监护病房的标准，对于改善早期治疗效果和患者舒适度至关重要。
