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激进主张:减少阿片类药物使用的前列腺切除术。

A Radical Proposition: Opioid-sparing Prostatectomy.

机构信息

Urology Department, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Urology Department, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

出版信息

Eur Urol Focus. 2020 Mar 15;6(2):215-217. doi: 10.1016/j.euf.2019.06.011. Epub 2019 Jun 21.

Abstract

Radical prostatectomy has largely become a procedure requiring a single day in the hospital with improving convalescence. Pre-operative counseling on perioperatively expectations including a discussion of pain management using non-opioid alternatives is critical to further improve postoperative recovery and limit narcotic use. Preoperative regional pain blocks and intraoperative multi-modal analgesia, and scheduled non-opioid pain medication alternatives can greatly limit opioid exposure perioperatively. Liberal use of acetaminophen and non-steroidal anti-inflammatories upon discharge may eliminate the need for narcotic prescriptions at the time of discharge.

摘要

根治性前列腺切除术在很大程度上已成为一种只需住院一天即可完成的手术,术后恢复情况也在不断改善。在术前咨询中,应围绕围手术期预期展开讨论,包括使用非阿片类药物进行疼痛管理,这对于进一步改善术后恢复和限制阿片类药物的使用至关重要。术前区域性疼痛阻滞和术中多模式镇痛,以及有计划的非阿片类药物镇痛替代方案,可大大限制围手术期阿片类药物的暴露。在出院时大量使用对乙酰氨基酚和非甾体抗炎药,可能会使出院时无需开具阿片类药物处方。

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