Center for Translational Injury Research.
Department of Surgery, McGovern Medical School at the University of Texas Health Science Center.
Curr Opin Crit Care. 2020 Dec;26(6):628-633. doi: 10.1097/MCC.0000000000000773.
Acute pain management in the surgical ICU is imperative. Effective acute pain management hastens a patient's return to normal function and avoid the negative sequelae of untreated acute pain. Traditionally, opioids have been the mainstay of acute pain management strategies in the surgical ICU, but alternative medications and management strategies are increasingly being utilized.
Extrapolating from lessons learned from enhanced recovery after surgery protocols, surgical intensivists are increasingly utilizing multimodal pain regimens (MMPRs) in critically ill surgical patients recovering from major surgical procedures and injuries. MMPRs incorporate both oral medications from several drug classes and regional blocks when feasible. In addition, although MMPRs may include opioids as needed, they are able to achieve effective pain control while minimizing opioid exposure.
Even after major elective surgery or significant injury, opioid-minimizing MMPRs can effectively treat acute pain.
外科重症监护室（SICU）中的急性疼痛管理至关重要。有效的急性疼痛管理可加速患者恢复正常功能，并避免未治疗的急性疼痛带来的负面后果。传统上，阿片类药物一直是 SICU 急性疼痛管理策略的主要药物，但目前越来越多地使用替代药物和管理策略。
从手术后加速康复方案中吸取的经验教训表明，外科重症监护医师越来越多地在接受大手术和创伤后恢复的重症外科患者中使用多模式疼痛管理方案（MMPR）。MMPR 结合了几种药物类别的口服药物和可行的区域阻滞。此外，尽管 MMPR 可能根据需要包含阿片类药物，但它们能够在最小化阿片类药物暴露的情况下实现有效的疼痛控制。
即使在接受大手术或重大创伤后，减少阿片类药物的 MMPR 也可以有效地治疗急性疼痛。
