胸外科手术后的疼痛和阿片类药物使用：我们的现状和未来方向。
Pain and Opioid Use After Thoracic Surgery: Where We Are and Where We Need To Go.
机构信息
Section of General Thoracic Surgery, UC Davis Health, Sacramento, California.
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan.
出版信息
Ann Thorac Surg. 2020 Jun;109(6):1638-1645. doi: 10.1016/j.athoracsur.2020.01.056. Epub 2020 Mar 3.
As many as one third of patients undergoing minimally invasive thoracic surgery and one half undergoing thoracotomy will have chronic pain, defined as pain lasting 2 to 3 months. There is limited information regarding predictors of chronic pain and even less is known about its impact on health-related quality of life, known as pain interference. Currently, there is a focus on decreased opioid prescribing after surgery. Interestingly, thoracic surgical patients are the least likely to be receiving opioids before surgery and have the highest rate of new persistent opioid use after surgery compared with other surgical cohorts. These studies of opioid use have identified important predictors of new persistent opioid use, but their findings are limited by failing to correlate opioid use with pain. The objectives of this invited review are to present the findings of pertinent studies of chronic pain and opioid use after thoracic surgery, "where we are," and to discuss gaps in our knowledge of these topics and opportunities for research to fill those gaps, "where we need to go."
多达三分之一接受微创胸腔手术的患者和一半接受开胸手术的患者将患有慢性疼痛，定义为持续 2 至 3 个月的疼痛。关于慢性疼痛的预测因素的信息有限，甚至更少的是关于其对健康相关生活质量的影响，即疼痛干扰。目前，人们的注意力集中在手术后减少阿片类药物的处方上。有趣的是，与其他手术队列相比，胸外科患者在手术前最不可能接受阿片类药物，并且在手术后新出现持续使用阿片类药物的比率最高。这些关于阿片类药物使用的研究已经确定了新出现持续使用阿片类药物的重要预测因素，但它们的发现受到限制，因为未能将阿片类药物的使用与疼痛相关联。本特邀评论的目的是介绍有关胸腔手术后慢性疼痛和阿片类药物使用的相关研究结果，即“我们所处的位置”，并讨论我们在这些主题的知识空白以及研究填补这些空白的机会，即“我们需要去的地方”。
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