Raffa Robert B, Pergolizzi Joseph V, Dungan George C, Miller Thomas L
Research and Development, Enalare Therapeutics, Princeton, USA.
Clinical Development, Enalare Therapeutics, Princeton, USA.
Cureus. 2025 Mar 2;17(3):e79913. doi: 10.7759/cureus.79913. eCollection 2025 Mar.
Upon the induction of general anesthesia, a predictable sequence of physiological changes occurs within the respiratory and neuromuscular systems. The sequelae of these changes include an assortment of postoperative pulmonary complications (PPCs), including postoperative respiratory depression (PORD), that are observed during the immediate postoperative period and in the post-anesthesia care unit (PACU). These adverse events are anticipated, because several of the drugs that are used during surgery (e.g., opioids, which are traditionally used to manage pain during and after surgery), albeit therapeutically beneficial, have these adverse effects as part of their pharmacology. Nevertheless, the effects are traditionally considered transitory. However, several studies provide evidence suggesting that PPC-related morbidity and mortality extend 30, 60, and even 90 days after discharge from the hospital. These studies are summarized and assessed in this narrative review. Although exact estimates vary depending on the definitions used, the type of surgery, patient population, and risk factors (such as age), it is clear that PORD and other PPCs can be severe postoperative complications with significant associated mortality risks that extend weeks to months after discharge from the hospital.
在全身麻醉诱导后,呼吸和神经肌肉系统会发生一系列可预测的生理变化。这些变化的后遗症包括术后肺部并发症(PPCs)的多种情况,包括术后呼吸抑制(PORD),这些在术后即刻以及麻醉后护理单元(PACU)中均可观察到。这些不良事件是可预期的,因为手术中使用的几种药物(例如,传统上用于手术期间和术后疼痛管理的阿片类药物),尽管具有治疗益处,但这些不良反应是其药理学的一部分。然而,传统上认为这些影响是暂时的。然而,多项研究提供的证据表明,与PPC相关的发病率和死亡率在出院后30天、60天甚至90天仍会持续存在。本叙述性综述对这些研究进行了总结和评估。尽管确切估计因所使用的定义、手术类型、患者群体以及风险因素(如年龄)而异,但很明显,PORD和其他PPCs可能是严重的术后并发症,具有显著的相关死亡风险,且在出院后数周甚至数月内仍持续存在。