Puntillo Filomena, Giglio Mariateresa, Varrassi Giustino
Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy.
Intensive Care and Pain Unit, Policlinico Hospital, Bari, Italy.
Pain Ther. 2021 Dec;10(2):909-925. doi: 10.1007/s40122-021-00286-5. Epub 2021 Jul 17.
Effective treatment of postoperative acute pain, together with early mobilization and nutrition, is one of the perioperative strategies advocated to improve surgical outcome and reduce the costs of hospitalization. Moreover, adequate pain control reduces perioperative morbidity related to surgical stress and can also prevent the incidence of chronic postoperative pain syndromes, whose treatment is still a challenge. The choice of the most appropriate analgesics depends not only on the drug class, but also on the most suitable route of administration, the best dosage for that route, and unique limitations and contraindications for every patient. In the present review, a comprehensive analysis was performed on the different routes of administration of acute postoperative pain medications and their indications and limitations, focusing on recent evidence and international recommendations.
有效治疗术后急性疼痛,同时配合早期活动和营养支持,是围手术期提倡的改善手术效果和降低住院费用的策略之一。此外,充分的疼痛控制可降低与手术应激相关的围手术期发病率,还能预防慢性术后疼痛综合征的发生,而慢性术后疼痛综合征的治疗仍是一项挑战。选择最合适的镇痛药不仅取决于药物类别,还取决于最合适的给药途径、该途径的最佳剂量以及每个患者独特的限制和禁忌证。在本综述中,对术后急性疼痛药物的不同给药途径及其适应证和局限性进行了全面分析,重点关注最新证据和国际建议。