在成年人腹腔镜尾切除术期间的疼痛管理:系统性审查
Stefan J Biput1, Ethan Slouha2, Jheanelle A Gregory3
1Medicine, St. George's University School of Medicine, St. George's, GRD.
Cureus
|February 12, 2024
概括
与开放式手术相比,腹腔镜尾切除术显著减少了术后疼痛和阿片类药物的使用. 增强的止痛策略,包括非阿片类药物选择,是控制疼痛和打击阿片类药物流行病的关键.
科学领域:
- 手术创新 在外科创新.
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 阿片类药物流行是一个主要的公共卫生危机,由处方阿片类药物滥用引发.
- 有效的术后疼痛管理对于手术恢复和减少阿片类药物依赖至关重要.
研究的目的:
- 研究腹腔镜尾切除术 (LA) 的止痛策略,以减少阿片类药物依赖.
- 为了比较LA的疼痛管理与开放尾切除术.
主要方法:
- 从2003-2023年对成人LA的研究进行了全面的文献综述.
- 在PubMed,ProQuest和ScienceDirect数据库中进行搜索,应用PRISMA指南.
- 包括18项同行评审的实验和观察研究.
主要成果:
- 与开放尾切除相比, laparoscopic尾切除始终显示手术后疼痛减少和阿片类药物处方率降低.
- 有效的非阿片类药物策略包括局部麻醉剂,脊柱/外皮麻醉,神经阻塞,NSAIDs和乙氨基.
- 接受LA治疗的患者经历了更好的结果,包括更短的恢复时间和更好的化品,进一步降低了阿片类药物需求.
结论:
- 腹腔镜尾切除术促进了转向非阿片类药物止痛治疗的转变,用于术后疼痛控制.
- 在手术环境中实施非阿片类药物战略对于应对阿片类药物流行病至关重要.
- 这种方法促进了更安全,更可持续的疼痛管理实践.
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