在心脏手术中进行外科手术期间的疼痛管理
Masseh Yakubi1, Sam Curtis1, Sibtain Anwar1,2
1St Bartholomew's Hospital, London, UK.
Current opinion in anaesthesiology
|November 11, 2024
概括
心脏手术后急性术后疼痛的管理正在从阿片类药物转向多式模式止痛药. 证据支持区域麻醉技术和过渡性疼痛服务,以改善患者的治疗结果.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 心脏外科手术 心脏外科手术
背景情况:
- 心脏手术后的急性术后疼痛带来了重大管理挑战.
- 传统的高剂量阿片类药物使用与不良影响有关,促使人们寻找替代策略.
- 基于证据的方法对于优化这种患者群体的疼痛控制至关重要.
研究的目的:
- 审查当前基于证据的策略,以管理心脏手术后的急性术后疼痛.
- 为了突出术后疼痛管理方面的进展.
- 强调从以阿片类药物为中心的转变到多式模式止痛方法.
主要方法:
- 审查当前证据和国际指导方针对心脏手术后的疼痛管理.
- 评估区域麻醉技术,包括带平面块.
- 评估过渡性疼痛服务的作用.
主要成果:
- 多模式止痛疗法得到了当前证据和心脏手术中术后疼痛管理指南的支持.
- 区域麻醉技术,如勃起脊柱平面和副肋间平面块,是有效和安全的,即使在抗凝血患者.
- 多学科的过渡性疼痛服务有效地管理了从住院护理到门诊护理的过渡.
结论:
- 心脏外科手术患者的术后疼痛管理方面的进展表明,多模式止痛的趋势.
- 区域麻醉技术为高剂量阿片类药物提供了安全有效的替代方案.
- 多学科过渡性疼痛服务在全面的患者护理中发挥着至关重要的作用.
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