Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.
Louisiana Addiction Research Center, Shreveport, LA, 71103, USA.
Curr Pain Headache Rep. 2023 Jul;27(7):183-192. doi: 10.1007/s11916-023-01110-9. Epub 2023 Apr 28.
The tissue damage and trauma associated with surgery almost always result in acute postoperative pain. The intensity of postoperative pain can range from mild to severe. Naltrexone is suitable for patients who do not wish to be on an agonist treatment such as methadone or buprenorphine. However, naltrexone has been shown to complicate postoperative pain management.
Multiple studies have found that the use of naltrexone can increase the opioid requirement for postoperative pain control. Other modalities exist that can help outside of opioids such as ketamine, lidocaine/bupivacaine, duloxetine, and non-pharmacological management can help manage pain. Multimodal pain regiments should also be employed in patients. In addition to traditional methods for postoperative pain management, other methods of acute pain control exist that can help mitigate opioid dependence and help control pain in patients who use naltrexone for their substance use disorders.
手术相关的组织损伤和创伤几乎总是导致急性术后疼痛。术后疼痛的强度可从轻度到重度不等。纳曲酮适用于不愿接受美沙酮或丁丙诺啡等激动剂治疗的患者。然而,纳曲酮已被证明会使术后疼痛管理复杂化。
多项研究发现,使用纳曲酮会增加阿片类药物治疗术后疼痛控制的需求。还有其他方法可以帮助控制疼痛,而不依赖阿片类药物,如氯胺酮、利多卡因/布比卡因、度洛西汀,非药物治疗也可以帮助管理疼痛。在患者中也应采用多模式疼痛治疗方案。除了传统的术后疼痛管理方法外,还存在其他急性疼痛控制方法,可以帮助减轻阿片类药物依赖,并帮助控制使用纳曲酮治疗物质使用障碍的患者的疼痛。