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神经科学重症监护病房的头痛管理

Headache Management in the Neuroscience Intensive Care Unit.

作者信息

Pomar-Forero Daniela, Ahmad Bakhtawar, Barlow Brooke, Busl Katharina M, Maciel Carolina B

机构信息

Department of Neurology, Division of Neurocritical Care, University of Florida College of Medicine, Gainesville, FL, 32611, USA.

Memorial Hermann, The Woodlands Medical Center, The Woodlands, TX, 77380, USA.

出版信息

Curr Pain Headache Rep. 2024 Dec;28(12):1273-1287. doi: 10.1007/s11916-023-01181-8. Epub 2023 Oct 24.

Abstract

PURPOSE OF REVIEW

Headache is a common symptom in the Neuroscience Intensive Care Unit (NeuroICU). Our goal is to provide an overview of approaches to headache management for common neurocritical care conditions.

RECENT FINDINGS

Headache disorders afflict nearly half of patients admitted to the NICU. Commonly encountered disorders featuring headache include cerebrovascular disease, trauma, and intracranial infection. Approaches to pain are highly variable, and multimodal pain regimens are commonly employed. The overall body of evidence supporting therapeutic strategies to manage headache in the critical care setting is slim, and pain control remains suboptimal in many cases with persistent reliance on opioids. Headache is a complex, frequently occurring phenomenon in the NeuroICU care setting. At present, literature on evidence-based practice for management of headache in the critical care setting remains scarce, and despite multimodal approaches, reliance on opioids is commonplace.

摘要

综述目的

头痛是神经科学重症监护病房(NeuroICU)的常见症状。我们的目标是概述常见神经重症监护病症的头痛管理方法。

最新发现

头痛疾病困扰着近一半入住神经重症监护病房的患者。常见的伴有头痛的病症包括脑血管疾病、创伤和颅内感染。疼痛处理方法差异很大,通常采用多模式镇痛方案。支持在重症监护环境中管理头痛的治疗策略的整体证据不足,在许多情况下,由于持续依赖阿片类药物,疼痛控制仍未达到最佳效果。头痛在神经重症监护病房护理环境中是一种复杂且频繁出现的现象。目前,关于重症监护环境中头痛管理的循证实践的文献仍然匮乏,尽管采用了多模式方法,但对阿片类药物的依赖却很常见。

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