胸部手术中的疼痛管理:将证据与实践联系起来
Vojislava Neskovic1, Ross Hofmeyr2, Izumi Kawagoe3
1Clinic for Anaesthesia and Critical Care, Military Medical Academy, Faculty of Medicine MMA, Belgrade, Serbia.
胸腔外围止痛不再是胸腔外科手术后疼痛的首选. 现在,替代性区域块和多式联络方法是治疗复杂胸痛的首选方法.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 胸部手术后的疼痛带来了重大的管理挑战.
- 胸部外周止痛疗法 (TEA) 从历史上来说是标准的,但正在发展.
- 最少侵入性技术和增强的恢复协议推动了疼痛管理的变化.
研究的目的:
- 审查胸部疼痛管理当前的挑战.
- 探索替代的区域止痛技术.
- 考虑未来的个性化胸部疼痛护理策略.
主要方法:
- 对当前指导方针和实践的文献综述.
- 分析从TEA转向替代区域区块的情况.
- 评估药理和非药理疼痛方式.
主要成果:
- 目前的指导方针不再强调TEA治疗胸痛.
- 视频辅助和机器人胸部手术有助于支脊椎和带平面块.
- 替代区块和多式联运战略的有效性正在进行评估.
结论:
- 建议在复杂的胸部外科手术后疼痛中使用综合区域技术和全身止痛疗法的多式疗法.
- 临床实践因资源,协议和专业知识而有所不同.
- 对胸部疼痛管理的普遍接受的护理标准仍未确定.
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