OBJECTIVE:To provide reference for postoperative rational selection of analgesia drugs and the optimization of an-algesia plan. METHODS:From the aspect of clinical pharmacists,postoperative pain therapy drugs involved in 6th-22nd chapter of Guidelines for Postoperative Pain Management (called Guideline for short) in the United States. RESULTS:The contents of the Guideline involving postoperative pain therapy drugs included the selection of perioperative therapy drugs and route of administra-tion,multimodal analgesic delivery regimen,individualized drug treatment program,medication monitoring,medication education and postoperative pain management program,etc. The preoperative application of opioids or non-steroidal anti-inflammatory drugs was not recommended in the Guideline due to not benefit from it;for patients who can be given drugs orally,oral administration should be preferred if opioids were administered,and intramuscular injection should be avoided. The multimodal analgesic treat-ment plan combined with non-drug intervention were recommend for postoperative pain. The individualized treatment plan should be chosen according to the patient's specific condition. Clinical pharmacists should pay attention to the degree of sedation respira-tion and the occurrence of ADR in the patients after surgery,and explained the postoperative pain management process,methods of reducing analgesic drugs after discharge to the patiens and their families. CONCLUSIONS:The Guideline about analgesic regimens requirements for perioperative patients provides a reference for clinicians to choose the appropriate individual analgesic regimen.%目的:为临床术后合理选择镇痛药物及优化镇痛方案提供参考.方法:从临床药师的角度,对2016年美国《术后疼痛管理指南》(简称《指南》)第6～22章涉及术后疼痛治疗药物的内容进行解读.结果:《指南》涉及术后疼痛治疗药物的内容包括围术期治疗药物与给药途径的选择、多模式镇痛给药方案、个体化药物治疗方案,以及患者的用药监护、用药教育、术后疼痛管理方案等.《指南》不推荐在术前给予患者阿片类药物或非选择性非甾体抗炎药,因为不能获益;对于术后可口服给药的患者,若给予阿片类药物应优先选择口服制剂,避免采用肌内注射方式给药.《指南》强推荐采用多模式镇痛治疗方案与非药物性干预相结合的手段治疗患者术后疼痛,并根据患者的具体病情选择个体化治疗方案;临床医师应重点监护术后患者的镇静程度、呼吸状态及不良反应发生情况,并应向患者及其家属讲解术后疼痛管理流程及出院后镇痛药物的减量方法.结论:《指南》对围术期患者镇痛给药方案的规定,可为临床医师选择合适的个体化药物镇痛方案提供参考.
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