预防急性至慢性术后疼痛过渡的当前概念和目标
Adeeb Oweidat1, Hari Kalagara2, Rakesh V Sondekoppam1
1Department of Anesthesia, University of Iowa Healthcare, Iowa City, Iowa.
Current opinion in anaesthesiology
|August 1, 2024
概括
慢性术后疼痛 (CPSP) 影响了三分之一的患者. 一种多学科的方法,包括预防性止痛和出院后的随访,是管理从急性疼痛过渡到慢性疼痛的关键.
科学领域:
- 疼痛医学 医学 疼痛医学
- 外科手术的结果
- 麻醉学 麻醉学
背景情况:
- 慢性术后疼痛 (CPSP) 影响了大约三分之一的手术后患者.
- CPSP对生活质量产生了重大影响,并产生了巨大的社会经济成本.
- 有效管理CPSP仍然是一个临床挑战.
研究的目的:
- 审查目前对CPSP开发和管理的理解.
- 确定CPSP的诱导因素和治疗策略.
- 探索防止从急性疼痛过渡到慢性疼痛的方法.
主要方法:
- 对CPSP风险因素 (患者,程序,环境) 的流行病学分析.
- 对疼痛管理的多学科策略的审查.
- 评估中枢和外周神经系统在疼痛慢性化中的作用.
- 评估多模式止痛方法和预防性止痛.
主要成果:
- 根据患者,手术或护理环境,可以对CPSP风险因素进行分类.
- 一种多学科的方法,从术前开始,延伸到放电后,至关重要.
- 多模式止痛和持续的随访对于管理急性至慢性疼痛过渡至关重要.
- 了解神经系统的作用为未来的治疗目标提供了潜在的机会.
结论:
- 为了减少CPSP,一个全面的,多学科的战略至关重要.
- 关键因素包括早期识别风险因素,尽量减少手术创伤和多式联络止痛.
- 建议在住院后继续监测和过渡性疼痛服务模型.
- 积极主动管理对于缓解慢性疼痛的发展和影响至关重要.
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