Ruppen Wilhelm, Schneider Tobias
Departement für Anästhesie, Universitätsspital Basel.
Ther Umsch. 2020;77(1):3-9. doi: 10.1024/0040-5930/a001143.
Opioid crisis: What now? A pain specialist's point of view In acute pain, opioids in combination with co-analgesics can be useful and indicated. It is important to evaluate and to treat every single patient individually. Therefore, experienced patient guidance is crucial in pain treatment to reduce the risk of side effects and inappropriate long-term opioid use. The indication and doses for opioids need continuous re-evaluation. Ineffective treatments with opioids have to be tapered. Furthermore, opioid prescription should always be limited in time with a plan to taper it to prevent misuse or even addiction. Alternative medical and non-medical treatment options are important as well. The following text gives advice on how to approach a patient with pain and contains a manual on how to handle opioids in different settings.
现状如何?一位疼痛专家的观点 在急性疼痛中,阿片类药物与辅助镇痛药联合使用可能是有用且适用的。对每一位患者进行单独评估和治疗非常重要。因此,经验丰富的患者指导对于疼痛治疗至关重要,以降低副作用风险和不适当的长期阿片类药物使用。阿片类药物的适应症和剂量需要持续重新评估。对无效的阿片类药物治疗必须逐渐减量。此外,阿片类药物处方应始终有时间限制,并制定逐渐减量的计划,以防止滥用甚至成瘾。替代医学和非医学治疗选择也很重要。以下文本提供了如何处理疼痛患者的建议,并包含在不同情况下如何使用阿片类药物的手册。