Ohnesorge Henning, Günther Veronika, Grünewald Matthias, Maass Nicolai, Alkatout İbrahim
Clinic of Anesthesiology and Operative Intensive Medicine, University Medical Center Schleswig-Holstein, Kiel, Germany
Clinic of Obstetrics and Gynecology, University Medical Center Schleswig-Holstein, Kiel, Germany
J Turk Ger Gynecol Assoc. 2020 Dec 4;21(4):287-297. doi: 10.4274/jtgga.galenos.2020.2020.0024. Epub 2020 Jun 5.
The efficiency and quality of postoperative pain management may be considered unsatisfactory in Europe, as well as in the United States. Notwithstanding our better understanding of the physiology of pain and the development of new analgesia procedures, the improvement in satisfaction of patients has not be enhanced to the same degree. Obstetrics and gynecology are no exception to this statement. In fact, obstetrics and gynecology are surgical departments in which patients experience the greatest severity of postoperative pain. Current concepts of postoperative pain management are largely based on the administration of systemic non-opioid and opioid analgesics, supplemented with regional analgesia procedures and/or peripheral nerve blockades and, in some cases, the administration of other pain-relieving pharmaceutical agents. Based on the existing body of evidence, it would be appropriate to develop procedure-related concepts of analgesia. The concepts are based on the special circumstances of the respective department, and the scheme of analgesia is aligned to the respective interventions. Generally, however, a surgeon’s individual experience in dealing with the procedures and substances could be more significant than the theoretical advantages demonstrated in preceding investigations.
在欧洲以及美国，术后疼痛管理的效率和质量可能都被认为不尽人意。尽管我们对疼痛生理学有了更深入的了解，并且开发了新的镇痛方法，但患者满意度的提升程度却没有达到相同水平。妇产科也不例外。事实上，妇产科是患者术后疼痛最为严重的外科科室。当前术后疼痛管理的理念主要基于全身性非阿片类和阿片类镇痛药的使用，并辅以区域镇痛方法和/或外周神经阻滞，在某些情况下，还会使用其他缓解疼痛的药物。基于现有的证据，制定与手术相关的镇痛理念是合适的。这些理念基于各个科室的特殊情况，镇痛方案与相应的手术操作相匹配。然而，一般来说，外科医生在处理手术和药物方面的个人经验可能比先前研究中显示的理论优势更为重要。
