Doan Lisa V, Blitz Jeanna
1Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, New York, NY USA.
2Department of Anesthesiology, Duke University School of Medicine, Durham, NC USA.
Curr Anesthesiol Rep. 2020;10(1):28-34. doi: 10.1007/s40140-020-00367-9. Epub 2020 Jan 10.
This review summarizes selected recent evidence on issues important for preoperative pain evaluation.
Opioids, though a mainstay of postoperative pain management, are associated with both short and increasingly recognized long-term risks, including persistent opioid use. Risk factors for high levels of acute postoperative pain as well as chronic postsurgical pain may overlap, including psychological factors such as depression, anxiety, and catastrophizing. Tools to predict those at risk for poor postoperative pain outcomes are being studied.
Preoperative pain and psychological factors can affect postoperative pain outcomes. More work is needed in the future to develop practical interventions in the preoperative period to address these factors.
本综述总结了近期有关术前疼痛评估重要问题的部分证据。
阿片类药物虽是术后疼痛管理的主要手段，但与短期及越来越被认识到的长期风险相关，包括持续使用阿片类药物。术后急性疼痛及慢性术后疼痛程度高的风险因素可能重叠，包括抑郁、焦虑和灾难化等心理因素。预测术后疼痛结果不佳风险人群的工具正在研究中。
术前疼痛和心理因素可影响术后疼痛结果。未来需要开展更多工作，以制定术前实用干预措施来解决这些因素。
