手术后从急性疼痛转变为慢性疼痛
Paul Glare1, Karin R Aubrey2, Paul S Myles3
1Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia.
Lancet (London, England)
|April 16, 2019
概括
类药物对治疗疼痛的依赖正在引发全球危机. 对于预防慢性手术后疼痛和减少阿片类药物滥用而言, 更安全的阿片类药物节约策略至关重要.
科学领域:
- 治疗疼痛
- 药理学
- 公共卫生
背景情况:
- 人们越来越依赖阿片类药物治疗急性和慢性疼痛,
- 手术后不适当的阿片类药物处方,尤其是在出院后,是阿片类药物流行的主要原因.
- 慢性术后疼痛影响10%的患者,通常从急性术后疼痛转变为抗阿片类药物神经病症.
研究的目的:
- 提供关于持续性术后疼痛的流行病学,社会影响和基本科学概述.
- 讨论治疗术后持续性疼痛的最新建议和进展.
- 促进治疗急性和慢性疼痛的更安全的止痛疗法,并预防阿片类药物诱导的过敏症.
主要方法:
- 关于阿片类药物在治疗疼痛方面的最新文献.
- 对手术后疼痛和与阿片类药物相关的死亡病例的流行病学数据进行分析.
- 对阿片类药物诱导的过敏症和替代疼痛管理策略的综合研究.
主要成果:
- 自1999年以来,美国的阿片类药物滥用和过量服用死亡人数增加了四倍,全球同样趋势.
- 持续的手术后疼痛往往是由于手术后疼痛控制不良而产生,并且表现出神经病的特征.
- 研究强调阿片类药物诱导的过敏症是治疗耐药性疼痛的一个因素,并强调需要使用阿片类药物节约的方法.
结论:
- 有效管理持续的术后疼痛需要了解从急性到慢性疼痛状态的过渡.
- 开发和实施更安全,更少使用阿片类药物的止痛疗法和非药物干预措施至关重要.
- 预防慢性术后疼痛是缓解阿片类药物危机的关键.
相关概念视频
Phase Transitions
22.9K
Whether solid, liquid, or gas, a substance's state depends on the order and arrangement of its particles (atoms, molecules, or ions). Particles in the solid pack closely together, generally in a pattern. The particles vibrate about their fixed positions but do not move or squeeze past their neighbors. In liquids, although the particles are closely spaced, they are randomly arranged. The position of the particles are not fixed—that is, they are free to move past their neighbors to...
22.9K
Properties of Transition Metals
29.7K
Transition metals are defined as those elements that have partially filled d orbitals. As shown in Figure 1, the d-block elements in groups 3–12 are transition elements. The f-block elements, also called inner transition metals (the lanthanides and actinides), also meet this criterion because the d orbital is partially occupied before the f orbitals.
29.7K
Cooperative Allosteric Transitions
8.7K
Cooperative allosteric transitions can occur in multimeric proteins, where each subunit of the protein has its own ligand-binding site. When a ligand binds to any of these subunits, it triggers a conformational change that affects the binding sites in the other subunits; this can change the affinity of the other sites for their respective ligands. The ability of the protein to change the shape of its binding site is attributed to the presence of a mix of flexible and stable segments in the...
8.7K
Cooperative Allosteric Transitions
2.6K
2.6K
Phase Transitions: Vaporization and Condensation
20.8K
The physical form of a substance changes on changing its temperature. For example, raising the temperature of a liquid causes the liquid to vaporize (convert into vapor). The process is called vaporization—a surface phenomenon. Vaporization occurs when the thermal motion of the molecules overcome the intermolecular forces, and the molecules (at the surface) escape into the gaseous state. When a liquid vaporizes in a closed container, gas molecules cannot escape. As these gas phase molecules...
20.8K
Phase Transitions: Sublimation and Deposition
19.9K
Some solids can transition directly into the gaseous state, bypassing the liquid state, via a process known as sublimation. At room temperature and standard pressure, a piece of dry ice (solid CO2) sublimes, appearing to gradually disappear without ever forming any liquid. Snow and ice sublimate at temperatures below the melting point of water, a slow process that may be accelerated by winds and the reduced atmospheric pressures at high altitudes. When solid iodine is warmed, the solid sublimes...
19.9K


