[小儿及青少年脊柱畸形矫正手术围手术期疼痛管理的进展]
[Progress in perioperative pain management of pediatric and adolescent spinal deformity corrective surgery].
作者信息
Wang Haozhong, Xiu Peng, Wang Lei, Song Yueming
机构信息
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 May 15;33(5):644-649. doi: 10.7507/1002-1892.201810122.
OBJECTIVE
To review the advances in perioperative pain management of pediatric and adolescent spinal deformity corrective surgery.
METHODS
Regular analgesics, drug administrations, and analgesic regimens were reviewed and summarized by consulting domestic and overseas related literatures about perioperative pain management of pediatric and adolescent spinal deformity corrective surgery in recent years.
RESULTS
As for perioperative analgesis regimens of pediatric and adolescent spinal deformity corrective surgery, regular analgesics include non-steroidal anti-inflammatory drugs, opioids, antiepileptic drugs, adrenergic agonists, and local anesthetic, . Besides drug administration by mouth, intravenous injection, and intramuscular injection, the administration also includes patient controlled analgesia, epidural injection, and intrathecal injection. Multimodal analgesia is the most important regimen currently.
CONCLUSION
Heretofore, a number of perioperative pain managements of pediatric and adolescent spinal deformity corrective surgery have been applied clinically, but the ideal regimen has not been developed. To design a safe and effective analgesic regimen needs further investigations.
目的
综述小儿及青少年脊柱畸形矫正手术围手术期疼痛管理的进展。
方法
通过查阅近年来国内外关于小儿及青少年脊柱畸形矫正手术围手术期疼痛管理的相关文献，对常用镇痛药、给药方式及镇痛方案进行回顾与总结。
结果
小儿及青少年脊柱畸形矫正手术围手术期镇痛方案中，常用镇痛药包括非甾体类抗炎药、阿片类药物、抗癫痫药物、肾上腺素能激动剂及局部麻醉药等。给药方式除口服、静脉注射及肌内注射外，还包括患者自控镇痛、硬膜外注射及鞘内注射。多模式镇痛是目前最重要的镇痛方案。
结论
目前临床上已应用多种小儿及青少年脊柱畸形矫正手术围手术期疼痛管理方法，但尚未形成理想的镇痛方案。设计安全有效的镇痛方案仍需进一步研究。
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