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Efficacy of relaxation therapy as an effective nursing intervention for post-operative pain relief in patients undergoing abdominal surgery: A systematic review and meta-analysis.放松疗法作为腹部手术患者术后疼痛缓解有效护理干预措施的疗效:一项系统评价与荟萃分析。
Exp Ther Med. 2019 Oct;18(4):2909-2916. doi: 10.3892/etm.2019.7915. Epub 2019 Aug 19.
3
American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Management of Patients on Preoperative Opioid Therapy.美国增强恢复和围手术期质量倡议联合共识声明:术前阿片类药物治疗患者的围手术期管理。
Anesth Analg. 2019 Aug;129(2):553-566. doi: 10.1213/ANE.0000000000004018.
4
Impact of preoperative patient education on the prevention of postoperative complications after major visceral surgery: the cluster randomized controlled PEDUCAT trial.术前患者教育对预防大内脏手术后并发症的影响:整群随机对照PEDUCAT试验
Trials. 2018 May 24;19(1):288. doi: 10.1186/s13063-018-2676-6.
5
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J Pain Res. 2017 Sep 25;10:2287-2298. doi: 10.2147/JPR.S144066. eCollection 2017.
6
Effect of Preoperative Opioid Exposure on Healthcare Utilization and Expenditures Following Elective Abdominal Surgery.术前阿片类药物暴露对择期腹部手术后医疗保健利用和费用的影响。
Ann Surg. 2017 Apr;265(4):715-721. doi: 10.1097/SLA.0000000000002117.
7
Preoperative Reduction of Opioid Use Before Total Joint Arthroplasty.全关节置换术前减少阿片类药物使用量
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Chronic pre-operative opioid use and acute pain after fast-track total knee arthroplasty.快速康复全膝关节置换术后的慢性术前阿片类药物使用与急性疼痛
Acta Anaesthesiol Scand. 2016 Apr;60(4):529-36. doi: 10.1111/aas.12667. Epub 2015 Dec 28.
9
Preoperative pain management education: a quality improvement project.术前疼痛管理教育:一项质量改进项目。
J Perianesth Nurs. 2015 Jun;30(3):221-7. doi: 10.1016/j.jopan.2015.01.013.
10
The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.长期阿片类药物治疗慢性疼痛的效果和风险:美国国立卫生研究院预防途径研讨会的系统评价。
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探索术前疼痛管理的非药物方法。

Exploring Non-pharmacological Methods for Pre-operative Pain Management.

作者信息

Patil Jayaditya Devpal, Sefen Jessica Atef Nassef, Fredericks Salim

机构信息

Royal College of Surgeons in Ireland (RCSI)-Bahrain, Al Muharraq, Bahrain.

出版信息

Front Surg. 2022 Mar 4;9:801742. doi: 10.3389/fsurg.2022.801742. eCollection 2022.

DOI:10.3389/fsurg.2022.801742
PMID:35317192
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8934410/
Abstract

The management of pain is an essential aspect of surgical care, and pain levels in post-operative patients vary case by case. Treating postoperative pain is crucial as it leads to better outcomes and reduces risk of long term pain. While post-operative analgesics has been the mainstay of treatment, this mini-review explores an emerging concept which is preoperative pain management, with promising potential. Such interventions include educating patients on the expected pain outcomes and available pain medications. Non-pharmacological methods such as relaxation exercises have also proven to be effective after abdominal surgery, and educating patients on the existence of such methods pre-operatively encourages them to make use of available therapies. A major area of importance is the pre-operative psychological and emotional wellbeing of patients, as it is a strong predictor of pain and pain prognosis. Cognitive Behavioral Therapy can be effectively used to tackle preoperative anxiety and reduce pain levels. Hypnosis is another developing modality for decreasing stress. Lastly, long term pre-operative opioid use has been linked with higher pain scores and longer pain duration. This provides the basis on which pre-operative opioid weaning can lead to favorable post-operative pain outcomes. While many of these methods have not been experimented on recipients of abdominal surgery in specific, it still paves the path for newer pain control strategies that can eventually be adopted for visceral surgery patients. This review points the reader and researchers to new and developing areas that hold the potential to revolutionize current established pain management guidelines.

摘要

疼痛管理是外科护理的一个重要方面,术后患者的疼痛程度因病例而异。治疗术后疼痛至关重要,因为它能带来更好的结果并降低长期疼痛的风险。虽然术后镇痛药一直是治疗的主要手段,但本综述探讨了一个新兴概念,即术前疼痛管理,其具有广阔的潜力。此类干预措施包括向患者介绍预期的疼痛结果和可用的止痛药物。非药物方法,如放松练习,在腹部手术后也已被证明是有效的,术前向患者介绍此类方法的存在会鼓励他们利用现有的治疗方法。一个重要的主要领域是患者术前的心理和情绪健康,因为它是疼痛和疼痛预后的有力预测指标。认知行为疗法可有效用于应对术前焦虑并降低疼痛程度。催眠是另一种减轻压力的新兴方式。最后,长期术前使用阿片类药物与更高的疼痛评分和更长的疼痛持续时间有关。这为术前阿片类药物戒断可导致良好的术后疼痛结果提供了依据。虽然其中许多方法尚未在腹部手术患者中进行具体试验,但它仍为最终可应用于内脏手术患者的更新疼痛控制策略铺平了道路。本综述向读者和研究人员指出了新的和正在发展的领域,这些领域有可能彻底改变当前既定的疼痛管理指南。