Tobias J D
Department of Child Health, University of Missouri, Columbia 65212, USA.
Pediatr Ann. 1997 Aug;26(8):490-500. doi: 10.3928/0090-4481-19970801-12.
Recent evidence has documented the deleterious physiologic effects of pain and the beneficial results of effective postoperative analgesia. As outlined in this article, a three-step approach is recommended depending on the severity of pain. The three-step approach utilizes a combination of NSAIDs, oral or intravenous opioids. In addition to selecting a particular opioid to use, the practitioner must also consider the route of administration and the mode of administration. All three choices may significantly impact on the efficacy of analgesia. While we continue to use primarily intravenous opioids to treat moderate and severe pain in the hospital setting, future formulations and developments may allow for the increased use of non-parenteral routes.
近期证据已证实疼痛有害的生理效应以及有效的术后镇痛所带来的有益结果。如本文所述，根据疼痛的严重程度，推荐采用三步法。三步法联合使用非甾体抗炎药、口服或静脉用阿片类药物。除了选择特定的阿片类药物使用外，从业者还必须考虑给药途径和给药方式。这三种选择都可能对镇痛效果产生显著影响。虽然在医院环境中我们仍主要使用静脉用阿片类药物来治疗中度和重度疼痛，但未来的制剂和发展可能会增加非肠道途径的使用。
