Borode Aishwarya S, Wadaskar Dhawal
Anesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jul 22;16(7):e65144. doi: 10.7759/cureus.65144. eCollection 2024 Jul.
The opioid crisis has significantly impacted pain management practices in spine surgery, prompting a critical reassessment of traditional approaches. While opioids have historically been effective for post-operative pain relief, their widespread use has led to substantial public health challenges, including addiction and overdose. This review explores alternative strategies to opioids in spine surgery, emphasizing non-opioid pharmacological options [e.g., nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, local anesthetics] and non-pharmacological interventions (e.g., physical therapy, cognitive-behavioral therapy). These alternatives aim to mitigate opioid-related risks while optimizing patient outcomes. Key findings highlight these approaches' efficacy, safety considerations, and practical implications. Recommendations include personalized pain management plans and multidisciplinary collaboration to enhance care delivery. Future directions suggest advancing research in innovative pain management technologies and promoting evidence-based practices to mitigate opioid dependence. Ultimately, integrating these strategies into clinical practice is essential for addressing the opioid crisis and ensuring quality care in spine surgery.
阿片类药物危机对脊柱手术中的疼痛管理实践产生了重大影响，促使人们对传统方法进行批判性重新评估。虽然阿片类药物在历史上对术后疼痛缓解有效，但其广泛使用导致了重大的公共卫生挑战，包括成瘾和过量用药。本综述探讨了脊柱手术中阿片类药物的替代策略，重点介绍了非阿片类药物选择（如非甾体抗炎药、肌肉松弛剂、局部麻醉剂）和非药物干预措施（如物理治疗、认知行为疗法）。这些替代方法旨在降低与阿片类药物相关的风险，同时优化患者预后。主要研究结果突出了这些方法的有效性、安全考量及实际意义。建议包括制定个性化疼痛管理计划和多学科协作以提高护理质量。未来的方向表明要推进创新疼痛管理技术的研究，并推广基于证据的实践以减轻阿片类药物依赖。最终，将这些策略整合到临床实践中对于应对阿片类药物危机和确保脊柱手术的优质护理至关重要。
