Pedoto Alessia, Fischer Gregory W, Mincer Joshua S
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, Department of Anesthesia and Critical Care Medicine, 1275 York Avenue, New York, NY, 10028, USA.
Best Pract Res Clin Anaesthesiol. 2024 Mar;38(1):74-80. doi: 10.1016/j.bpa.2024.05.001. Epub 2024 May 9.
The objectives of this minireview are two-fold. The first is to discuss the evolution of opioid analgesia in perioperative medicine in the context of thoracic non-cardiac surgery. Current standard-of-care, aiming to optimize analgesia and limit undesirable side effects, is discussed in the context of multimodal analgesia, specifically enhanced recovery after thoracic surgery pathways. The second is to review a developing research program that may ultimately add another element to the personalization of analgesic plans for individual cancer patients based on optimizing oncological outcomes. Termed "precision oncoanalgesia," this emerging field aims to elucidate how individual patient-specific tumor omics (genomics, transcriptomics, etc.) may mediate the effects of analgesic drugs on oncological recurrence and survival.
本综述的目的有两个。第一个目的是在胸科非心脏手术的背景下，讨论围手术期医学中阿片类镇痛的演变。在多模式镇痛的背景下，特别是在胸科手术后加速康复途径中，讨论了旨在优化镇痛并限制不良副作用的当前护理标准。第二个目的是回顾一个正在发展的研究项目，该项目最终可能会基于优化肿瘤学结果，为个体癌症患者的镇痛计划个性化增加另一个要素。这个新兴领域被称为“精准肿瘤镇痛”，旨在阐明个体患者特异性肿瘤组学（基因组学、转录组学等）如何介导镇痛药对肿瘤复发和生存的影响。
