Hooten W Michael
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Charlton 1-145, 200 First Street SW, Rochester, MN 55905, USA.
Phys Med Rehabil Clin N Am. 2020 May;31(2):265-277. doi: 10.1016/j.pmr.2020.01.006. Epub 2020 Mar 11.
Numerous guidelines targeting safe use of opioids for chronic pain have been published but substantial challenges persist in clinical application of best practice recommendations. This article describes a pragmatic approach to clinical care of adults with chronic pain receiving long-term opioid therapy. Three components of care are emphasized: (1) medical and mental health assessment before initiating opioid therapy, (2) clinical surveillance during the course of long-term opioid therapy, and (3) clinical considerations and strategies governing opioid tapering. A pressing need exists for ongoing research to further clarify the optimal role that long-term opioid therapy has in treatment of chronic pain.
针对慢性疼痛安全使用阿片类药物的众多指南已发布，但在最佳实践建议的临床应用中仍存在重大挑战。本文描述了一种针对接受长期阿片类药物治疗的慢性疼痛成人患者的务实临床护理方法。强调了护理的三个组成部分：（1）开始阿片类药物治疗前的医学和心理健康评估，（2）长期阿片类药物治疗过程中的临床监测，以及（3）指导阿片类药物减量的临床考虑因素和策略。迫切需要进行持续研究，以进一步阐明长期阿片类药物治疗在慢性疼痛治疗中的最佳作用。
