在术后脊柱外科手术患者的疼痛管理的综合方法:先进的策略和未来的方向
Dhruba Podder1, Olivia Stala1, Rahim Hirani1
1School of Medicine, New York Medical College, Valhalla, NY 10595, USA.
Neurology international
|June 25, 2025
概括
在脊柱手术中有效的术后疼痛管理正在发展. 多模式止痛,将药物和区域阻断与非药物治疗相结合,可以改善恢复和减少阿片类药物的使用.
科学领域:
- 疼痛管理 疼痛管理
- 脊柱外科手术 脊柱外科手术
- 麻醉学 麻醉学
背景情况:
- 手术后的疼痛显著影响脊柱手术的结果,影响高达50%的患者.
- 疼痛控制不良导致动员延迟,住院时间延长和慢性疼痛.
- 传统的以阿片类药物为中心的方法正在被综合战略所取代.
研究的目的:
- 审查目前和新兴的策略,以有效的术后疼痛管理在脊柱外科手术.
- 突出转向个性化,多模式疼痛管理方法的转变.
- 讨论创新技术和该领域的未来方向.
主要方法:
- 对手术后脊柱疼痛管理的当前文献进行系统审查.
- 药理学,区域麻醉和非药理学干预措施的合成.
- 探索新兴技术,如人工智能,生物标志物和神经调节.
主要成果:
- 多模式止痛 (MMA) 是基石,整合NSAIDs,乙氨基, gabapentinoids 和区域阻塞 (例如,勃起器脊柱平面阻塞).
- 非药物方法 (早期动员,CBT,正念) 增强恢复和解决生物心理社会因素.
- 神经调节,人工智能和纳米技术在耐火性疼痛和个性化治疗方面表现有前途.
结论:
- 多模式和个性化方法对于脊柱手术后的最佳疼痛控制至关重要.
- 手术后增强恢复 (ERAS) 协议有效减少阿片类药物的使用和住院.
- 未来的研究应该专注于人工智能引导的分析,再生疗法和长期功能结果.
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