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加速康复外科时代的术后疼痛管理:概述。

Postoperative pain management in the era of ERAS: An overview.

机构信息

University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9068, USA.

Section of Surgical Pathophysiology 7621, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.

出版信息

Best Pract Res Clin Anaesthesiol. 2019 Sep;33(3):259-267. doi: 10.1016/j.bpa.2019.07.016. Epub 2019 Jul 25.

Abstract

Enhanced recovery after surgery (ERAS) programmes are increasingly becoming standard of care for several surgical procedures. However, compliance with ERAS protocols including pain management protocols remains poor. The PROSPECT (PROcedure-SPEcific Postoperative Pain ManagemenT) collaboration provides evidence-based, procedure-specific pain management recommendations presented as preoperative, intraoperative and postoperative interventions as well as surgical interventions that are easy to access, transparent and relevant to clinicians. This approach should facilitate incorporation of pain management recommendations in an ERAS protocol and improve compliance with the protocols. This article presents an improved approach to developing pain management guidelines as well as a pragmatic approach to procedure-specific perioperative pain management that could be incorporated in an ERAS pathway.

摘要

术后加速康复(ERAS)方案越来越多地成为多种外科手术的标准治疗方法。然而,ERAS 方案(包括疼痛管理方案)的依从性仍然很差。PROSPECT(手术特定术后疼痛管理)合作组织提供了循证的、特定于手术的疼痛管理建议,这些建议以术前、术中、术后干预以及易于获取、透明且与临床医生相关的手术干预的形式呈现。这种方法应该有助于将疼痛管理建议纳入 ERAS 方案,并提高对方案的依从性。本文提出了一种改进的疼痛管理指南制定方法和一种实用的手术特定围手术期疼痛管理方法,可以纳入 ERAS 途径。

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