Donato S, Malisano A M, Dogareschi T, Chiarandini P, Spasiano A, Pasetto A
Cattedra di Anestesia e Rianimazione, Università degli Studi, Udine.
Chir Ital. 1995;47(6):26-9.
Epidural analgesia with local anesthetics and opioids is one of the most effective methods for postoperative pain control. In critical patients it seems to improve outcome as well as pain control. This technique works better when started in the intraoperative time. Epidural analgesia is safe on surgical wards if nursing staff is trained in managing epidural catheters and in early detection and treatment of major and minor side effects. Nursing staff cooperates with the Acute Pain Service doctors and nurses who are on call on a 24 hour basis. Many perspective and retrospective studies showed a very low incidence of major side effects with epidurals. So we can consider it safe and effective even if we consider its invasiveness.
使用局部麻醉药和阿片类药物进行硬膜外镇痛是术后疼痛控制最有效的方法之一。对于重症患者,它似乎既能改善预后,又能控制疼痛。这种技术在术中开始使用时效果更佳。如果护理人员接受过管理硬膜外导管以及早期发现和处理主要及次要副作用方面的培训,那么硬膜外镇痛在外科病房是安全的。护理人员与随时待命的急性疼痛服务医生和护士密切合作。许多前瞻性和回顾性研究表明,硬膜外镇痛的主要副作用发生率非常低。因此,即便考虑到其侵入性,我们仍可认为它是安全有效的。