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本文引用的文献

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Opioid weaning and pain management in postsurgical patients at the Toronto General Hospital Transitional Pain Service.多伦多综合医院过渡性疼痛服务中心对术后患者的阿片类药物减量及疼痛管理
Can J Pain. 2018 Aug 20;2(1):236-247. doi: 10.1080/24740527.2018.1501669. eCollection 2018.
2
A Systematic Review of Behavioral Interventions to Decrease Opioid Prescribing After Surgery.手术治疗后减少阿片类药物处方的行为干预措施的系统评价。
Ann Surg. 2020 Feb;271(2):266-278. doi: 10.1097/SLA.0000000000003483.
3
The effect of post-operative NSAID administration on bone healing after elective foot and ankle surgery.择期足踝手术后 NSAID 给药对骨愈合的影响。
Foot Ankle Surg. 2020 Jun;26(4):457-463. doi: 10.1016/j.fas.2019.05.016. Epub 2019 May 31.
4
Cryotherapy Reduced Postoperative Pain in Gynecologic Surgery: A Randomized Controlled Trial.冷冻疗法减轻妇科手术术后疼痛:一项随机对照试验。
Pain Res Treat. 2019 Mar 4;2019:2405159. doi: 10.1155/2019/2405159. eCollection 2019.
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Intravenous Acetaminophen Versus Placebo in Post-bariatric Surgery Multimodal Pain Management: a Meta-analysis of Randomized Controlled Trials.静脉用对乙酰氨基酚与安慰剂在减重手术后多模式疼痛管理中的比较:一项随机对照试验的荟萃分析。
Obes Surg. 2019 Apr;29(4):1420-1428. doi: 10.1007/s11695-019-03732-8.
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One-year results from the first US-based enhanced recovery after cardiac surgery (ERAS Cardiac) program.美国首个心脏手术后强化恢复(ERAS 心脏)项目的一年期结果。
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Non-opioid analgesic modes of pain management are associated with reduced postoperative complications and resource utilisation: a retrospective study of obstructive sleep apnoea patients undergoing elective joint arthroplasty.非阿片类镇痛药在疼痛管理中的应用模式与减少术后并发症和资源利用有关:一项择期关节置换手术的阻塞性睡眠呼吸暂停患者的回顾性研究。
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9
Ketamine for pain management.氯胺酮用于疼痛管理。
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成人择期手术后出院时疼痛药物处方的共识声明。

Consensus Statement for the Prescription of Pain Medication at Discharge after Elective Adult Surgery.

作者信息

Clarke Hance A, Manoo Varuna, Pearsall Emily A, Goel Akash, Feinberg Adina, Weinrib Aliza, Chiu Jenny C, Shah Bansi, Ladak Salima S J, Ward Sarah, Srikandarajah Sanjho, Brar Savtaj S, McLeod Robin S

机构信息

Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.

Transitional Pain Service, Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.

出版信息

Can J Pain. 2020 Mar 8;4(1):67-85. doi: 10.1080/24740527.2020.1724775.

DOI:10.1080/24740527.2020.1724775
PMID:33987487
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7951150/
Abstract

This Consensus Statement provides recommendations on the prescription of pain medication at discharge from hospital for opioid-naïve adult patients who undergo elective surgery. It encourages health care providers (surgeons, anesthesiologists, nurses/nurse practitioners, pain teams, pharmacists, allied health professionals, and trainees) to (1) use nonopioid therapies and reduce the prescription of opioids so that fewer opioid pills are available for diversion and (2) educate patients and their families/caregivers about pain management options after surgery to optimize quality of care for postoperative pain. These recommendations apply to opioid-naïve adult patients who undergo elective surgery. This consensus statement is intended for use by health care providers involved in the management and care of surgical patients. A modified Delphi process was used to reach consensus on the recommendations. First, the authors conducted a scoping review of the literature to determine current best practices and existing guidelines. From the available literature and expertise of the authors, a draft list of recommendations was created. Second, the authors asked key stakeholders to review and provide feedback on several drafts of the document and attend an in-person consensus meeting. The modified Delphi stakeholder group included surgeons, anesthesiologists, residents, fellows, nurses, pharmacists, and patients. After multiple iterations, the document was deemed complete. The recommendations are not graded because they are mostly based on consensus rather than evidence.

摘要

本共识声明针对接受择期手术的未使用过阿片类药物的成年患者出院时的止痛药物处方提供建议。它鼓励医疗保健提供者(外科医生、麻醉师、护士/执业护士、疼痛治疗团队、药剂师、相关健康专业人员及实习生):(1)使用非阿片类疗法并减少阿片类药物的处方,从而减少可用于转移的阿片类药丸数量;(2)对患者及其家属/护理人员进行术后疼痛管理选项的教育,以优化术后疼痛的护理质量。这些建议适用于接受择期手术的未使用过阿片类药物的成年患者。本共识声明供参与外科患者管理和护理的医疗保健提供者使用。采用了改良的德尔菲法就这些建议达成共识。首先,作者对文献进行了范围界定审查,以确定当前的最佳实践和现有指南。根据现有文献和作者的专业知识,制定了一份建议草案清单。其次,作者请关键利益相关者对该文件的多个草案进行审查并提供反馈,并参加一次面对面的共识会议。改良的德尔菲利益相关者小组包括外科医生、麻醉师、住院医师、研究员、护士、药剂师和患者。经过多次迭代后,该文件被认为完成。这些建议未进行分级,因为它们大多基于共识而非证据。