From the Department of Surgery and Center for Translational Injury Research, The University of Texas McGovern Medical School at Houston, Houston, Texas.
J Trauma Acute Care Surg. 2024 Apr 1;96(4):537-541. doi: 10.1097/TA.0000000000004193. Epub 2023 Nov 13.
Effective acute pain control is mandatory after injury. Opioids continue to be a pillar acute pain management of strategies despite not being as effective as some nonnarcotic alternatives. An acute pain management strategy after trauma should be thoughtful, effective, and responsible. A thoughtful approach includes managing a patient's expectations for acute pain control and ensuring that interventions purposefully and rationally affect the domain of pain that is uncontrolled. An effective pain management strategy includes a multimodal approach using acetaminophen, nonsteroidal anti-inflammatory drugs, and regional anesthesia. A responsible acute pain management approach includes knowing the relative strengths of the opioids prescribed and standardized approach to opioid prescribing at discharge to minimize diversion. Acute pain management is quite understudied, and future considerations include a reliable objective measurement of pain and the evaluation of nonmedication acute pain interventions.
有效的急性疼痛控制是受伤后的必要措施。尽管一些非麻醉性替代方法不如阿片类药物有效，但阿片类药物仍然是急性疼痛管理策略的重要组成部分。创伤后急性疼痛管理策略应该深思熟虑、有效且负责任。深思熟虑的方法包括管理患者对急性疼痛控制的期望，并确保干预措施有目的地、合理地影响未控制的疼痛领域。有效的疼痛管理策略包括使用对乙酰氨基酚、非甾体抗炎药和区域麻醉的多模式方法。负责任的急性疼痛管理方法包括了解所开阿片类药物的相对强度，并制定标准化的阿片类药物出院处方方法，以最大程度地减少药物滥用。急性疼痛管理的研究还很不足，未来的考虑因素包括疼痛的可靠客观测量和非药物急性疼痛干预的评估。
