术后疼痛管理和癌症结果:叙述性审查
Maria F Ramirez1, Amanda Strang2, Gavin Roland2
1Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Journal of pain research
|December 11, 2023
概括
有效的癌症疼痛管理使用了量身定制的外科手术期间的方法. 阿片类药物对严重疼痛至关重要,但由于滥用问题和癌症复发的持续研究,它们的作用正在演变.
科学领域:
- 在瘤学瘤学.
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 与癌症相关的疼痛是一种普遍且使人衰弱的症状,影响患者的生活质量和功能.
- 疼痛可能源于癌症本身,诊断/治疗程序或治疗副作用.
- 最佳的术后疼痛控制需要个性化的策略.
研究的目的:
- 在外科手术期间审查急性癌症疼痛的药理管理.
- 强调疼痛管理对癌症复发的影响.
- 讨论阿片类药物在癌症疼痛治疗中的演变作用.
主要方法:
- 对急性外科手术期癌症疼痛的药理干预措施的文献综述.
- 对当前治疗指南和研究结果的分析.
- 专注于包括区域麻醉,局部麻醉,非阿片类止痛药和阿片类药物在内的药物.
主要成果:
- 建议采用多式疗法,结合区域麻醉,非阿片类止痛药 (胺,德克斯梅托米丁,利多卡因,NSAIDs) 和阿片类药物.
- 尽管有关阿片类药物流行病的担忧,阿片类药物仍然对中度至重度的癌症疼痛至关重要.
- 从随机对照试验中,将阿片类药物使用与负面癌症结果联系在一起的证据是不确定的.
结论:
- 术后疼痛管理需要个性化策略.
- 由于滥用,对治疗癌症疼痛的阿片类药物的使用受到审查,需要仔细考虑.
- 需要进一步的研究来澄清术后阿片类药物使用与癌症复发之间的关系.
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