Langlade A
Hôpital Lariboisière, Département d'Anesthésie-Réanimation, Paris.
Cah Anesthesiol. 1995;43(3):251-7.
During the postoperative period, the efficacy of opioid treatment is different among patients. Indeed, an extreme variability exists between patients, concerning their analgesic requirement and their sensibility to opioids. To improve opioid analgesia, some empiric considerations must be observed: 1) Techniques of opioid administration must allow to titrate analgesic requirement. Patient Controlled Analgesia represents a real improvement and should be developed. 2) Occurrence of side effects must be avoided. The combination of different analgesics must be prescribed systematically, if there is no contraindication. 3) Opoid side effects must be appropriately treated, in order to improve the quality of analgesia. These simple measures require regular evaluation of opioid analgesia, and treatment of the side effects.
在术后期间，阿片类药物治疗的效果在患者之间存在差异。事实上，患者之间在镇痛需求和对阿片类药物的敏感性方面存在极大的变异性。为了改善阿片类药物镇痛效果，必须遵循一些经验性的考量：1）阿片类药物的给药技术必须能够滴定镇痛需求。患者自控镇痛是一项切实的改进措施，应该予以推广。2）必须避免副作用的发生。如果没有禁忌证，应系统地开具不同镇痛药物的联合处方。3）必须对阿片类药物的副作用进行适当治疗，以提高镇痛质量。这些简单的措施需要对阿片类药物镇痛效果进行定期评估，并对副作用进行治疗。
