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已发表论文
麻醉后监护室的术后疼痛管理：一个更新
Authors Luo J, Min S
Received 30 May 2017
Accepted for publication 19 August 2017
Published 16 November 2017 Volume 2017:10 Pages 2687—2698
DOI https://doi.org/10.2147/JPR.S142889
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 3
Editor who approved publication: Dr Katherine Hanlon
Abstract: Acute
postoperative pain remains a major problem, resulting in multiple undesirable
outcomes if inadequately controlled. Most surgical patients spend their
immediate postoperative period in the postanesthesia care unit (PACU), where
pain management, being unsatisfactory and requiring improvements, affects
further recovery. Recent studies on postoperative pain management in the PACU
were reviewed for the advances in assessments and treatments. More objective
assessments of pain being independent of patients’ participation may be
potentially appropriate in the PACU, including photoplethysmography-derived
parameters, analgesia nociception index, skin conductance, and pupillometry,
although further studies are needed to confirm their utilities. Multimodal
analgesia with different analgesics and techniques has been widely used. With theoretical basis of preventing central sensitization, preventive
analgesia is increasingly common. New opioids are being developed with
minimization of adverse effects of traditional opioids. More intravenous
nonopioid analgesics and adjuncts (such as dexmedetomidine and dexamethasone)
are introduced for their opioid-sparing effects. Current evidence suggests that
regional analgesic techniques are effective in the reduction of pain and stay
in the PACU. Being available alternatives to epidural analgesia, perineural
techniques and infiltrative techniques including wound infiltration,
transversus abdominis plane block, local infiltration analgesia, and
intraperitoneal administration have played a more important role for their
effectiveness and safety.
Keywords: postoperative complications, anesthesia recovery period, pain assessment, pain management, acute pain
Keywords: postoperative complications, anesthesia recovery period, pain assessment, pain management, acute pain
