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急性围手术期疼痛服务:影响、组织和未来方向。

The Acute Perioperative Pain Service: Impact, Organization, and Future Directions.

机构信息

Columbia University Irving Medical Center, New York, USA.

NewYork-Presbyterian/Columbia Univ Med Ctr, 622 W 168th St, NY, PH5-133 10032, New York, USA.

出版信息

Curr Pain Headache Rep. 2023 Sep;27(9):399-405. doi: 10.1007/s11916-023-01133-2. Epub 2023 Jun 24.

Abstract

PURPOSE OF REVIEW

The Acute Perioperative Pain Service has been established as a relatively new but important concept and service in clinical patient care. Many surgical institutions have dedicated inpatient acute pain services with variable compositions. This review aims to investigate the purpose, clinical and economic implications, and future direction of the Acute Perioperative Pain Service (APPS).

RECENT FINDINGS

There is growing evidence of the multiple benefits of a dedicated APPS, especially pertaining to patients at higher risk of poorly controlled postoperative pain. Healthcare providers furthermore realize the importance of the perioperative pain management continuity of care, consisting of preoperative pain evaluations and post-discharge follow-up in an outpatient pain management setting, in coordination with the primary teams. The Transitional Pain Service (TPS) has emerged as the next step in this evolution and has been successfully implemented at various medical centers. With the growing number of surgical procedures and the increasing complexity of the patient population, effective management of acute postoperative pain continues to be challenging, despite ongoing advances in clinical care, analgesic modalities, and research. The APPS is becoming the clinical standard of care for managing postoperative pain, and its role continues to expand worldwide.

摘要

目的综述

急性围手术期疼痛服务作为一个相对较新但重要的临床患者护理理念和服务已经建立。许多外科机构都设有专门的住院急性疼痛服务,其组成各不相同。本综述旨在探讨急性围手术期疼痛服务(APPS)的目的、临床和经济意义以及未来方向。

最近的发现

越来越多的证据表明,专门的 APPS 具有多种益处,特别是对于术后疼痛控制不佳风险较高的患者。医疗保健提供者还意识到围手术期疼痛管理连续性护理的重要性,包括术前疼痛评估和出院后在门诊疼痛管理环境中的随访,与主要团队协调。过渡性疼痛服务(TPS)是这一演变的下一步,已在多个医疗中心成功实施。随着手术数量的增加和患者群体的日益复杂,尽管临床护理、镇痛方式和研究不断进步,急性术后疼痛的有效管理仍然具有挑战性。APPS 正在成为管理术后疼痛的临床标准护理,其作用在全球范围内不断扩大。

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