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过渡性疼痛服务:更新。

Transitional Pain Service: An Update.

机构信息

Department of Anaesthesiology Rescue- and Pain Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.

Department of Anaesthesiology and Critical Care, Hospital General Universitario de Valencia, Valencia, Spain.

出版信息

Curr Pain Headache Rep. 2024 Jun;28(6):457-464. doi: 10.1007/s11916-024-01239-1. Epub 2024 Mar 26.

Abstract

PURPOSE OF REVIEW

Chronic Postsurgical Pain (CPSP) and the risk for long-term opioid dependency are known complications following major surgery. The idea of Transitional Pain Service (TPS) has been introduced as an interdisciplinary setting to manage pain in the perioperative continuum. We expand on the basic framework and principles of TPS and summarize the current evidence of the TPS and possible interventions to adress postoperative pain. Areas of future work in TPS-related research are discussed.

RECENT FINDINGS

Several studies support the effectiveness of TPS in reducing opioid consumption in the perioperative period and following discharge. Some studies also show an improvement in functional outcome with TPS with patients reporting lower pain severity and pain interference. The TPS aims to halt the progress of acute postoperative pain to CPSP by providing longitudinal support with patient-centered care. While some studies suggest a positive impact of TPS implementation in terms of reduction in postoperative opioid consumption and improvement of some functional outcomes, direct evidence in terms of reduction in the incidence of CPSP is still missing. The cost-effectiveness of TPS and the expansion of TPS through e-health services and digital applications also need to be evaluated.

摘要

目的综述

慢性术后疼痛(CPSP)和长期阿片类药物依赖是大手术后已知的并发症。过渡性疼痛服务(TPS)的理念已被引入,作为一种跨学科的设置,以管理围手术期的疼痛。我们扩展了 TPS 的基本框架和原则,并总结了 TPS 的现有证据以及可能用于解决术后疼痛的干预措施。讨论了 TPS 相关研究的未来工作领域。

最新发现

几项研究支持 TPS 在减少围手术期和出院后阿片类药物消耗方面的有效性。一些研究还表明,TPS 可改善患者的功能结果,患者报告疼痛严重程度和疼痛干扰较低。TPS 通过提供以患者为中心的纵向支持,旨在阻止急性术后疼痛向 CPSP 的进展。虽然一些研究表明 TPS 的实施在减少术后阿片类药物消耗和改善某些功能结果方面具有积极影响,但仍缺乏减少 CPSP 发生率的直接证据。还需要评估 TPS 的成本效益以及通过电子健康服务和数字应用扩展 TPS。

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