在整形外科手术中治疗术后疼痛的多模式方法:综合性综述
1Department of Oral and Maxillofacial Surgery, Goldschleger School of Dentistry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Oral and Maxillofacial Surgery Unit, Dental Division, Shamir Medical Center, Tzrifin, Be'er Ya'akov, Israel.
International journal of oral and maxillofacial surgery
|February 18, 2025
概括
在整形外科手术后有效的疼痛管理涉及多模式策略. 结合冷却,光疗法,增强恢复协议和有针对性的技术,可以优化恢复并减少阿片类药物的使用.
科学领域:
- 口腔和牙面部外科手术
- 疼痛管理 疼痛管理
- 多模式止痛疗法 多模式止痛疗法
背景情况:
- 手术后的疼痛显著影响了整形手术后的康复和患者舒适度.
- 优化疼痛管理对于成功的手术结果和患者满意度至关重要.
研究的目的:
- 综合综合地审查和综合多模式策略来管理骨架手术后的疼痛.
- 评估各种干预措施的有效性,包括冷却疗法,基于光的治疗,增强的恢复协议和有针对性的技术.
主要方法:
- 一项文献搜索确定了13项研究,包括11项随机对照试验,涉及430名患者.
- 由于研究异质性,进行了叙事综合,将干预分为四种主要方法.
- 基于证据的建议被组织成一个表格.
主要成果:
- 与传统冷却相比,疗显示出优异的疼痛和胀减少.
- 基于光的疗法 (低水平激光疗法,光生物调节) 改善了早期疼痛控制和功能恢复.
- 手术后增强恢复 (ERAS) 协议与较低的疼痛评分和减少阿片类药物需求有关.
- 针对性技术,如神经阻塞和针点刺激,证明了急性疼痛缓解的潜力.
结论:
- 结合各种策略的多模式方法对于在整形外科手术中有效的疼痛管理至关重要.
- 建议制定个性化治疗计划,以优化疼痛控制,同时尽量减少阿片类药物消费.
- 以更大的样本规模和更长的随访期进行进一步的研究是有必要的,以加强证据的质量.
更多相关视频
相关概念视频
Analgesia and Pain Management
422
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
422
General Anesthesia: Overview
187
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
187
Opioid Analgesics: Synthetic and Semisynthetic Opioids
207
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
207
Parenteral Anesthetics: Overview
92
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
92
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
39
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
39
Opioid Analgesics: Morphine and Other Natural Cogeners
165
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
165


