Huang Li, Zhang Tianhao, Wang Kaixin, Chang Bingcheng, Fu Daan, Chen Xiangdong
Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
The Second Affiliated Hospital of Guizhou, University of Traditional Chinese Medicine, Guiyang, 550003, China.
Pain Ther. 2024 Aug;13(4):745-766. doi: 10.1007/s40122-024-00619-0. Epub 2024 Jun 5.
Enhanced Recovery After Surgery (ERAS) protocols have substantially proven their merit in diminishing recuperation durations and mitigating postoperative adverse events in geriatric populations undergoing colorectal cancer procedures. Despite this, the pivotal aspect of postoperative pain control has not garnered the commensurate attention it deserves. Typically, employing a multimodal analgesia regimen that weaves together nonsteroidal anti-inflammatory drugs, opioids, local anesthetics, and nerve blocks stands paramount in curtailing surgical complications and facilitating reduced convalescence within hospital confines. Nevertheless, this integrative pain strategy is not devoid of pitfalls; the specter of organ dysfunction looms over the geriatric cohort, rooted in the abuse of analgesics or the complex interplay of polypharmacy. Revolutionary research is delving into alternative delivery and release modalities, seeking to allay the inadvertent consequences of analgesia and thereby potentially elevating postoperative outcomes for the elderly post-colorectal cancer surgery populace. This review examines the dual aspects of multimodal analgesia regimens by comparing their established benefits with potential limitations and offers insight into the evolving strategies of drug administration and release.
术后加速康复（ERAS）方案已充分证明其在缩短老年结直肠癌手术患者的康复时间和减轻术后不良事件方面的优势。尽管如此，术后疼痛控制的关键环节尚未得到应有的充分关注。通常，采用将非甾体抗炎药、阿片类药物、局部麻醉剂和神经阻滞相结合的多模式镇痛方案对于减少手术并发症和促进患者在医院内缩短康复期至关重要。然而，这种综合疼痛管理策略并非没有缺陷；由于镇痛药滥用或多种药物的复杂相互作用，老年患者群体面临器官功能障碍的风险。前沿研究正在探索替代给药和释放方式，以减轻镇痛带来的意外后果，从而有可能提高老年结直肠癌手术后患者的术后康复效果。本综述通过比较多模式镇痛方案的既定益处和潜在局限性，审视了其两个方面，并深入探讨了药物给药和释放的不断演变的策略。
