Eng J, Sabanathan S
Department of Thoracic Surgery, Bradford Royal Infirmary, UK.
J R Coll Surg Edinb. 1993 Apr;38(2):62-8.
The severity of postoperative pain after thoracotomy means that total analgesia cannot be achieved with a single method or agent without significant side-effects. Recent advances in our understanding of the mechanism of pain generation and maintenance mean that measures prior to surgery greatly affect the requirement for postoperative analgesia. We review the methods available for post-thoracotomy analgesia in the light of our knowledge of peripheral and central mechanisms of neuronal hypersensitivity. The combination of opiate premedication, preoperative non-steroidal anti-inflammatory drugs (NSAIDs), preincisional regional block and postoperative continuous paravertebral block together with NSAIDs may be the ideal combination for near total analgesia following thoracotomy.
开胸术后疼痛的严重性意味着，采用单一方法或药物无法在无明显副作用的情况下实现完全镇痛。我们对疼痛产生和维持机制认识的最新进展表明，术前采取的措施会极大地影响术后镇痛的需求。鉴于我们对神经元超敏反应外周和中枢机制的了解，我们回顾了开胸术后镇痛可用的方法。阿片类药物术前用药、术前非甾体抗炎药（NSAIDs）、切开前区域阻滞以及术后持续椎旁阻滞联合NSAIDs，可能是开胸术后近乎完全镇痛的理想组合。
