Department of Anesthesiology, Vanderbilt University School of Medicine, 1301 Medical Center Drive, TVC 4619, Nashville, TN 37221, USA; Perioperative Medicine Fellowship, Hi-RiSE Perioperative Optimization Clinic, Perioperative Consult Service, VUMC ERAS Executive Steering Committee, Vanderbilt University Medical Center, 1301 Medical Center Drive, TVC 4648, Nashville, TN 37232, USA.
Department of Anesthesiology, Vanderbilt University School of Medicine, 1301 Medical Center Drive, TVC 4619, Nashville, TN 37221, USA; Perioperative Medicine Fellowship, Hi-RiSE Perioperative Optimization Clinic, Perioperative Consult Service, VUMC ERAS Executive Steering Committee, Vanderbilt University Medical Center, 1301 Medical Center Drive, TVC 4648, Nashville, TN 37232, USA.
Anesthesiol Clin. 2022 Mar;40(1):35-58. doi: 10.1016/j.anclin.2021.11.001.
Opioid-based analgesia in the perioperative period can provide excellent pain control, but this approach exposes the patient to avoidable side effects and possible harm. Optimal analgesia, an approach that targets the fastest functional recovery with adequate pain control while minimizing side effects, can be achieved with opioid minimization. Many different options for nonopioid multimodal analgesia exist and have been shown to be efficacious, with certain modalities being more beneficial for specific surgeries. This review will present the evidence and practical tips for these management strategies.
围手术期使用阿片类药物镇痛可以提供极好的疼痛控制效果，但这种方法会使患者面临不必要的副作用和潜在危害。通过减少阿片类药物用量，可以实现以最快速度恢复功能并充分控制疼痛的同时将副作用最小化的最佳镇痛。有许多不同的非阿片类药物多模式镇痛选择，并且已经证明其具有疗效，某些方法对特定手术更为有益。本综述将介绍这些管理策略的证据和实用技巧。
