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手术后增强康复 (ERAS) 共识对降低阿片类药物作用的药理新生儿疼痛管理的建议
Mercedes Pilkington1,2, Brandon Pentz3, Kristin Short4
1Department of Surgery, Division of Pediatric General and Thoracic Surgery, University of Toronto Temerty Faculty of Medicine, Toronto, Canada mpilkington@ariadnelabs.org.
BMJ paediatrics open
|October 9, 2024
概括
基于证据的指导方针建议定期使用乙氨基,并考虑用于新生儿疼痛管理的局部区域止痛药. 这些策略旨在尽量减少接受手术的新生儿的阿片类药物使用,确保更好地控制疼痛,副作用更少.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 新生儿手术 新生儿手术
- 疼痛管理 疼痛管理
背景情况:
- 为儿科和新生儿护理建立了手术后增强康复 (ERAS) 准则.
- 对于管理新生儿外科手术期疼痛的基于证据的建议,存在极大需求.
- 在新生儿外科护理中,最大限度地优化镇痛,同时最大限度地减少不良影响至关重要.
研究的目的:
- 制定关于在外科手术期间管理新生儿疼痛的共识建议.
- 在新生儿中建立基于证据的阿片类药物缓解疼痛管理策略.
- 为指导进行手术的新生儿疼痛的药理管理.
主要方法:
- 一个国际指导方针制定委员会采用了修改后的德尔菲共识过程.
- 系统的文献审查和对非阿片类药物和局部区域止痛药研究的批判性评估.
- 建议使用推,评估,开发和评估等级 (GRADE) 框架进行评估.
主要成果:
- 研究人口包括32周以上的新生儿,妊娠年龄在30天内出生.
- 出现了两个关键建议:定期使用乙氨基和考虑局部区域止痛药.
- 中等质量的证据支持这些建议;对于其他非阿片类药物辅助剂,证据不足.
结论:
- 基于证据的,ERAS驱动的建议被开发出来,以减少新生儿的阿片类药物暴露.
- 进一步的研究是必要的,以完善多式模式的疼痛管理策略,为这一群体.
- 这些指导方针旨在改善疼痛控制,并尽量减少新生儿手术患者的副作用.
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