Hanna Magdi, Montero Matamala Antonio, Perrot Serge, Varrassi Giustino
Department of Anesthesiology, University of London, London, GBR.
Department of Surgery, University of Lleida, Lleida, ESP.
Cureus. 2022 Feb 21;14(2):e22465. doi: 10.7759/cureus.22465. eCollection 2022 Feb.
It is crucial that acute pain be promptly and adequately treated in order to prevent it from transitioning to chronic pain, a devastating and sometimes permanent condition that is challenging to treat and associated with disability, reduced quality of life, and depression. Guidelines for the treatment of acute low-back pain (LBP) are predicated on assumptions that all acute LBP is benign, temporary, and traditionally treated with a "wait and see" approach. LBP is far from a monolithic condition: etiology, the presence of underlying conditions, mental health status, social situation, patient's age and occupation, and comorbidities all present different risk factors for chronic LBP that should be considered in treating acute LBP or other forms of acute pain. A multimodal approach to acute pain has been shown to be safe and effective. In particular, the combination product of oral dexketoprofen and tramadol has been shown effective in controlling acute pain, which spares the use of opioids and is well tolerated. Chronic pain must be viewed as a global health crisis, and the timely and adequate control of acute painful conditions is a good strategy to reduce its prevalence. Experts at Roma Pain Days discussed this important topic which is the foundation of this review.
及时、充分地治疗急性疼痛至关重要,以防止其转变为慢性疼痛,慢性疼痛是一种破坏性的、有时甚至是永久性的疾病,治疗具有挑战性,且与残疾、生活质量下降和抑郁相关。急性下背痛(LBP)的治疗指南基于这样的假设,即所有急性LBP都是良性的、暂时的,传统上采用“观察等待”的方法进行治疗。LBP远非单一病症:病因、潜在疾病的存在、心理健康状况、社会状况、患者的年龄和职业以及合并症,所有这些都为慢性LBP呈现出不同的风险因素,在治疗急性LBP或其他形式的急性疼痛时应予以考虑。已证明多模式治疗急性疼痛的方法是安全有效的。特别是,口服右酮洛芬和曲马多的复方制剂已被证明在控制急性疼痛方面有效,这避免了使用阿片类药物,且耐受性良好。慢性疼痛必须被视为一场全球健康危机,及时、充分地控制急性疼痛状况是降低其患病率的一项良好策略。罗马疼痛日的专家们讨论了这一重要话题,这也是本综述的基础。