摘要
腹部手术后中重度疼痛的发生率高达40%,是影响患者术后康复质量的重要危险因素之一。近年来微创外科、镇痛技术和新型镇痛药物不断发展和创新,但在控制内脏痛和炎性痛等方面仍然面临极大挑战。本指南专家组针对术前宣教和预防性镇痛在改善术后镇痛中的作用、不同类型区域阻滞或局部浸润技术的方案选择、非甾体抗炎药在多模式镇痛中的效果、不同类型的镇痛药物对术后疼痛的影响(如κ受体激动剂对内脏痛的影响)等腹部手术围手术期疼痛管理中的若干热点问题,系统回顾了近年来国内外发表的相关文献,评价其证据等级并结合我国临床实际,形成15条推荐意见,旨在为腹部手术患者围手术期疼痛规范化管理提供指导及决策依据。
The incidence of moderate to severe pain is as high as 40%in patients after abdominal surgery.Uncontrolled pain is a major risk factor that negatively affects postoperative recovery and quality of life.With advance and innovation in minimally invasive surgery,pain management techniques,and new analgesic drugs,there is still great challenge in controlling visceral pain and inflammation-related pain.The present guideline focuses on hot topics in optimization of perioperative pain management in patients undergoing abdominal surgery including the effect of preoperative education and preemptive analgesia on pain management,the selection of regional nerve blocks or local infiltration techniques and their effects on pain management,the role of non-steroid anti-inflammation drugs in multimodal analgesia,and the different analgesics on pain intensity(especially the effect of Kappa agonist on visceral pain).This guideline systematically reviews the evidence-based medicine in recent literature and forms 15 recommendations which aim to provide important guidance and decision-making strategies for standardized perioperative pain management.
作者
中华医学会外科学分会
中华医学会麻醉学分会
赵玉沛
俞卫锋
张太平
杨建军
穆东亮
Chinese Society of Surgery of Chinese Medical Association;Chinese Society of Anesthesiology of Chinese Medical Association;Zhao Yupei;Yu Weifeng(不详;Department of General Surgery,Peking Union Medical College Hospital,Beijing 100730,China;Department of Anesthesiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Anesthesiology,the First Affiliated Hospital of Wenzhou University,Wenzhou 325000,China)
出处
《中华普通外科杂志》
北大核心
2025年第7期497-504,共8页
Chinese Journal of General Surgery
关键词
指南
疼痛
腹部手术
麻醉
Guideline
Pain
Abdominal surgery
Anesthesia
