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腹部及下肢手术中的区域镇痛方式——疗效比较

Regional analgesia modalities in abdominal and lower limb surgery - comparison of efficacy.

作者信息

Peršec Jasminka, Šerić Monika

机构信息

1Clinic for Anesthesiology, Reanimatology and Intensive Care Medicine, Clinical Hospital Dubrava; 2School of Dental Medicine, University of Zagreb, Croatia.

出版信息

Acta Clin Croat. 2019 Jun;58(Suppl 1):101-107. doi: 10.20471/acc.2019.58.s1.15.

Abstract

A significant component of all surgical procedures and postoperative treatment is pain management.Due to the physiological and psychological advantages of pain relief, it is one of the foremost indicators of quality of care. Today, there are various modalities of pain reduction, aimed to reduce patient discomfort andminimize side effects, which can be divided by therapeutic agents used (opioid or non-opioid), route of administration (intravenous, regional, oral, etc.) and modality (controlled by patients or "as needed"). Although opioids have proven to be very effective pain relief agents and are commonly used in postoperative analgesia, concerns about their side effects have spurred the development of modified, multimodal treatments that seek to minimize opioid use and associated drawbacks. Enhanced recovery protocols that emphasize sparing administration of opioids are growing in importance, andresulting in reduced length of hospital stay after abdominal and lower limb surgery. To further improve such protocols and optimize postoperative care for individual patient needs, it is imperative to fully assess the efficacy of available drugs and analgesia modalities.

摘要

所有外科手术及术后治疗的一个重要组成部分是疼痛管理。由于缓解疼痛在生理和心理方面的益处,它是护理质量的首要指标之一。如今,有多种减轻疼痛的方式,旨在减轻患者不适并将副作用降至最低,这些方式可根据所使用的治疗药物(阿片类或非阿片类)、给药途径(静脉内、区域、口服等)和模式(患者自控或“按需”)进行分类。尽管阿片类药物已被证明是非常有效的止痛剂,且常用于术后镇痛,但对其副作用的担忧促使了改良的多模式治疗方法的发展,这些方法旨在尽量减少阿片类药物的使用及其相关弊端。强调减少阿片类药物使用的加速康复方案正变得越来越重要,并已使腹部和下肢手术后的住院时间缩短。为了进一步改进此类方案并根据个体患者需求优化术后护理,全面评估现有药物和镇痛方式的疗效至关重要。

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