...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Techniques in regional anesthesia & pain management. >Pain Relief After Cesarean Section
【24h】

Pain Relief After Cesarean Section

机译：剖腹产后的疼痛缓解

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Management of acute pain after cesarean section has evolved considerably over the past decade. In many institutions, intravenous patient-controlled analgesia and neuraxial opioids have replaced traditional intramuscular opioid injections. The general approach to pain after cesarean section is changing, shifting away from traditional opioid-based therapy toward a "multimodal" or "balanced" approach. Multimodal pain therapy involves the use of a potent opioid regimen, such as patient-controlled analgesia or neuraxial opioids, in combination with other classes of analgesic drugs. Theoretically, the use of analgesic drugs in combination allows for additive or even synergistic effects in reducing pain while decreasing the side effects produced by each class of drug because smaller drug doses are required. Typical analgesic regimens include opioids; nonopioid analgesics, such as acetaminophen; and nonsteroidal anti-inflammatory drugs, with the variable addition of local anesthetic techniques. Despite current advances in postoperative pain therapy, pain relief may still be inadequate for a substantial number of women. This may be particularly true as they make the transition from relative dependency on potent opioid regimens to full dependency on oral analgesics on the second postoperative day. A recent randomized controlled trial (P. Angle, S. Halpern, B. Leighton, et al, manuscript in preparation) examining pain relief after cesarean section revealed inadequate pain relief in 33% of women who received intrathecal morphine 0.2 mg followed by acetaminophen with codeine on a patient-request basis on the first postoperative day. This was compared with a 9% incidence in women who received regular doses of naproxen in addition to existing pain therapy. The use of naproxen, however, did not affect the incidence of inadequate analgesia on the second postoperative day, with both control and treatment groups experiencing similar incidences of inadequate pain relief respectively (27% v 28%). Further optimization of existing regimens as well as more effective monitoring of pain over the course of hospitalization should lead to improved pain relief. General recommendations are made in the following report.
机译：在过去的十年中，剖宫产后急性疼痛的治疗已有很大发展。在许多机构中，静脉内自控镇痛和神经轴阿片替代了传统的肌内阿片注射。剖宫产后疼痛的一般方法正在改变，从传统的基于阿片类药物的治疗转向“多模式”或“平衡”治疗。多峰镇痛疗法涉及与其他类型的镇痛药联合使用有效的阿片类药物疗法，例如患者自控镇痛或神经轴阿片类药物。从理论上讲，止痛药的组合使用在减轻疼痛的同时具有累加甚至协同作用，同时减少了每种药物产生的副作用，因为需要的药物剂量较小。典型的镇痛方案包括阿片类药物;非阿片类镇痛药，如对乙酰氨基酚;和非甾体类抗炎药，以及各种局部麻醉技术。尽管目前在术后疼痛治疗方面取得了进步，但对于许多女性而言，缓解疼痛仍可能不足。这可能是特别正确的，因为他们在术后第二天从对阿片类药物的相对依赖过渡到对口服镇痛药的完全依赖。最近一项随机对照试验（P. Angle，S。Halpern，B。Leighton等，准备中的手稿）检查剖宫产后的疼痛缓解情况，发现33％鞘内注射吗啡0.2 mg接受对乙酰氨基酚的妇女缓解疼痛的程度不足术后第一天根据患者要求提供可待因。相比之下，除了现有的疼痛疗法外，接受常规剂量萘普生治疗的女性发病率为9％。然而，萘普生的使用并没有影响术后第二天镇痛不充分的发生率，对照组和治疗组的疼痛缓解不充分的发生率分别相似（27％对28％）。进一步优化现有治疗方案，以及在住院过程中更有效地监控疼痛，应可改善疼痛缓解。以下报告提出了一般性建议。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号