在整形外科手术中增强手术后恢复 (ERAS) 协议:阿片类药物或非阿片类药物?
1Department of Anesthesia, Intensive Care, and Pain Therapy, ASST Orthopaedic Traumatological Specialist Center G. Pini, Milan, Italy.
Journal of pain research
|April 3, 2025
概括
手术后增强恢复 (ERAS) 协议减少了骨科手术中阿片类药物的使用. 虽然无阿片类药物治疗的疼痛治疗有希望,但骨科的证据是不确定的,需要进一步研究以获得最佳的患者护理.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 在外科手术后的护理.
背景情况:
- 手术后增强恢复 (ERAS) 协议优化了整形外科的术后护理.
- 片类药物传统上控制了术后疼痛,但由于阿片类药物危机和慢性疼痛的发展,引起了人们的担忧.
- 越来越需要在ERAS协议中重新评估阿片类药物使用.
研究的目的:
- 审查骨科手术中ERAS协议的演变和组件.
- 探索向多式模式疼痛管理和减少阿片类药物依赖的转变.
- 检查目前的证据,比较骨科ERAS中基于阿片类药物和无阿片类药物的止痛疗法.
主要方法:
- 在骨科手术中对ERAS协议的文献综述.
- 对比阿片类药物和无阿片类药物止痛策略的研究分析.
- 对疼痛管理,康复结果和阿片类药物消费的检查.
主要成果:
- 骨科ERAS协议倡导多式疼痛管理,整合区域神经阻断和非阿片类药物.
- 在骨科ERAS中,有限的研究直接比较了阿片类和无阿片类止痛药.
- 一些证据表明,无阿片类药物策略可能会改善恢复并减少某些环境中的疼痛和阿片类药物使用,但对骨科的数据是不确定的.
结论:
- 埃拉斯 (ERAS) 协议提供了对外科手术期间疼痛管理的整体方法,旨在降低阿片类药物风险.
- 优化有效的疼痛控制和患者安全之间的平衡至关重要.
- 需要进一步的研究来完善在骨科手术中无阿片类药物或减少阿片类药物的疼痛管理的临床指南.
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