Abebe Melkam Mulugeta, Arefayne Nurhusen Riskey, Temesgen Mamaru Mollalign, Admass Biruk Adie
Department of Anesthesia, College of Medicine & Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ann Med Surg (Lond). 2022 Aug 2;80:104322. doi: 10.1016/j.amsu.2022.104322. eCollection 2022 Aug.
Worldwide, there is an increasing trend of performing more complex operations in a day care setting, usually driven by economic considerations. Provision of appropriate pain relief is still inadequate in this setting. Poor pain control and adverse effects of opioids provided for pain control are common reasons for readmission, with human and economic consequences. The aim of this review was to develop evidence-based protocol for pain management of day surgery in a resource limited setting.
After formulating the key questions, scope, and eligibility criteria for the articles to be included, advanced search strategy of electronic sources from data bases and websites was conducted. Screening of literatures was conducted with proper appraisal checklist. This review was reported in accordance with preferred reporting items for systematic reviews and meta-analysis (PRISMA) 2020 statement.
A total of 333 articles were identified from data bases and websites using an electronic search. 45 articles were removed for duplication and 87 studies were excluded after reviewing titles and abstracts. At the screening stage, 73 articles were retrieved and evaluated for eligibility. Finally, 40 studies met the eligibility criteria and were included in this systematic review.
Day surgery encourages patients to mobilize soon after surgery and empowers them to manage their own pain. Thus, preoperative patient education and high-quality perioperative pain management are paramount. With increasing healthcare demands for more day-case procedures, multi-modal analgesic techniques in the perioperative period with good extension of analgesia into the postoperative discharge period are essential.
在全球范围内，受经济因素驱动，在日间手术环境中进行更复杂手术的趋势日益增加。在这种情况下，提供适当的疼痛缓解措施仍然不足。疼痛控制不佳以及用于疼痛控制的阿片类药物的不良反应是再次入院的常见原因，会带来人力和经济方面的后果。本综述的目的是制定在资源有限的环境中进行日间手术疼痛管理的循证方案。
在制定了纳入文章的关键问题、范围和纳入标准后，对来自数据库和网站的电子资源进行了高级检索策略。使用适当的评估清单对文献进行筛选。本综述按照系统评价和荟萃分析的首选报告项目（PRISMA）2020声明进行报告。
通过电子检索从数据库和网站共识别出333篇文章。45篇文章因重复被剔除，87项研究在审阅标题和摘要后被排除。在筛选阶段，检索到73篇文章并评估其是否符合纳入标准。最终，40项研究符合纳入标准并被纳入本系统评价。
日间手术鼓励患者术后尽快活动，并使他们能够自行管理疼痛。因此，术前患者教育和高质量的围手术期疼痛管理至关重要。随着对更多日间手术程序的医疗需求不断增加，围手术期采用多模式镇痛技术并将良好的镇痛效果延伸至术后出院期至关重要。
