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药物和非药物助眠剂能否减轻术后疼痛并减少阿片类药物的使用?文献综述。

Can pharmacological and non-pharmacological sleep aids reduce post-operative pain and opioid usage? A review of the literature.

作者信息

Petrie Kyla, Matzkin Elizabeth

机构信息

Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX.

Department of Orthopedics, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

Orthop Rev (Pavia). 2019 Dec 2;11(4):8306. doi: 10.4081/or.2019.8306.

Abstract

Sleep is important for our health and well-being and is especially pertinent to orthopedic surgery because it has been shown to play a role in pain tolerance. Knowing the benefits of sleep, one way to positively impact patients' pain and recovery post-surgery is to encourage sleep. Zolpidem, a pharmacologic sleep aid, has been shown to decrease opioid consumption, reduce pain, and increase quality of life when briefly used after orthopedic procedures. Cognitive Behavioral Therapy for Insomnia (CBT-I), a nonpharmacologic sleep aid, has been shown to increase the quality of sleep and sleep time, decrease sleep onset latency, decrease pain, and help patients maintain those gains. Because of the dangers of opioids, it is important for physicians to search for alternative methods to manage their patients' pain, like zolpidem and CBT-I. More research is needed to determine which method may be the most efficacious and how these can be integrated into patient care.

摘要

睡眠对我们的健康和幸福至关重要,对骨科手术尤为关键,因为睡眠已被证明在疼痛耐受性方面发挥作用。了解睡眠的益处后,积极影响患者术后疼痛和恢复的一种方法是鼓励睡眠。唑吡坦是一种药物助眠剂,已证明在骨科手术后短期使用时可减少阿片类药物的消耗、减轻疼痛并提高生活质量。失眠认知行为疗法(CBT-I)是一种非药物助眠方法,已证明可提高睡眠质量和睡眠时间、缩短入睡潜伏期、减轻疼痛,并帮助患者维持这些改善。由于阿片类药物存在风险,医生寻找替代方法来管理患者疼痛(如唑吡坦和CBT-I)非常重要。需要更多研究来确定哪种方法可能最有效,以及如何将这些方法纳入患者护理中。

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本文引用的文献

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Improve postoperative sleep: what can we do?改善术后睡眠:我们能做些什么?
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The opioid epidemic: impact on orthopaedic surgery.阿片类药物流行:对骨科手术的影响。
J Am Acad Orthop Surg. 2015 May;23(5):267-71. doi: 10.5435/JAAOS-D-14-00163.

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