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通过跨部门协作迈向精准医学,优化术后加速康复中的术后疼痛管理:一项叙述性综述

Revitalizing Postoperative Pain Management in Enhanced Recovery After Surgery via Inter-departmental Collaboration Toward Precision Medicine: A Narrative Review.

作者信息

Komasawa Nobuyasu

机构信息

Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Miki-cho, JPN.

出版信息

Cureus. 2024 Apr 25;16(4):e59031. doi: 10.7759/cureus.59031. eCollection 2024 Apr.

Abstract

This narrative review explores the crucial aspects of postoperative pain management within the framework of Enhanced Recovery After Surgery (ERAS). It emphasizes the significance of effective and secure pain management, highlighting its impact on patient well-being, surgical outcomes, and hospital stays. The inadequacy of perioperative pain relief increases the risk of persistent postoperative pain, emphasizing the need to challenge the notion that pain is expected after surgery. The goals of postoperative pain management extend beyond mere relief, encompassing comfortable sleep, pain-free rest, and liberation from pain during initial recovery. Inadequate pain management can lead to complications such as heightened postoperative bleeding and an increased risk of thrombosis. The review delves into various analgesic methods, their complications, and safety measures. ERAS programs, focused on reducing complications and medical costs, emphasize the importance of judicious postoperative pain management and active rehabilitation. The review discusses complications associated with analgesic methods like opioids, epidural analgesia, and adjuvant analgesics. Collaboration within the perioperative management team is crucial for effective postoperative pain relief. Interdepartmental collaboration is essential for evaluating surgical procedures, analgesic methods, and crisis management strategies. The review concludes by integrating precision medicine into postoperative pain management, emphasizing the potential of genetic information in assessing pain sensitivity. It underscores the importance of inter-departmental collaboration and information gathering for the successful implementation of precision medicine tailored to each facility's perioperative management systems. Additionally, the impact of artificial intelligence (AI) on preoperative risk assessment and innovative monitoring techniques is discussed, paving the way for the advancement of precision medicine in postoperative pain management.

摘要

本叙述性综述探讨了术后加速康复(ERAS)框架内术后疼痛管理的关键方面。它强调了有效且安全的疼痛管理的重要性,突出了其对患者福祉、手术结果和住院时间的影响。围手术期疼痛缓解不足会增加术后持续性疼痛的风险,这凸显了挑战术后疼痛不可避免这一观念的必要性。术后疼痛管理的目标不仅限于缓解疼痛,还包括舒适睡眠、无痛休息以及在初始恢复期间摆脱疼痛。疼痛管理不当可能导致术后出血增加和血栓形成风险升高等并发症。该综述深入探讨了各种镇痛方法、其并发症及安全措施。ERAS计划侧重于减少并发症和医疗成本,强调了明智的术后疼痛管理和积极康复的重要性。该综述讨论了与阿片类药物、硬膜外镇痛和辅助镇痛药等镇痛方法相关的并发症。围手术期管理团队内部的协作对于有效的术后疼痛缓解至关重要。部门间协作对于评估手术程序、镇痛方法和危机管理策略至关重要。该综述通过将精准医学纳入术后疼痛管理得出结论,强调了基因信息在评估疼痛敏感性方面的潜力。它强调了部门间协作和信息收集对于成功实施针对每个机构围手术期管理系统的精准医学的重要性。此外,还讨论了人工智能(AI)对术前风险评估和创新监测技术的影响,为术后疼痛管理中精准医学的进步铺平了道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce3b/11127797/f1d78f00aabc/cureus-0016-00000059031-i01.jpg

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