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Continuous Infusion Nonsteroidal Anti-Inflammatory Drugs for Perioperative Pain Management

机译:连续输注非甾体抗炎药,用于围手术期疼痛管理

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Purpose: To review the use of continuous infusion (CI) nonsteroidal anti-inflammatory drugs (NSAIDs) as an alternative modality for pain control in surgical patient populations. Methods: A PubMed and MEDLINE search was conducted from 1964 through February 2016 using the following search terms alone or in combinations: continuous, infusion, nonsteroidal anti-inflammatory drug, diclofenac, ibuprofen, indomethacin, ketoprofen, ketorolac, and surgery. All English-language, prospective and retrospective, adult and pediatric studies evaluating intravenous or intramuscular CI NSAIDs for surgical pain were evaluated for inclusion in this review. Results: Twenty four prospective and retrospective publications evaluating CI NSAIDs were identified: 12 in abdominal surgery, 7 in orthopedic surgery, and 5 in pediatric surgery. Specific CI NSAIDs utilized included diclofenac, indomethacin, ketoprofen, and ketorolac. Most studies compared the CI NSAID to placebo or an alternative analgesic and evaluated pain control, supplemental opioid use, and related adverse effects. In these surgical populations, CI NSAIDs decreased opioid consumption, alongside provision of adequate pain control. While long-term adverse effects were rarely collected, a decrease in nausea and sedation was often seen with the CI NSAID groups. Conclusions: In the abdominal, orthopedic, and pediatric surgical populations, CI NSAIDs represent a feasible alternative modality for perioperative pain control.
机译:目的:审查使用连续输注(CI)非甾体抗炎药(NSAID)作为手术患者群体中疼痛控制的替代方式。方法:PubMed和Medline搜索是从1964年到2016年2月进行的,使用以下搜索术语或组合:连续,输注,非甾体抗炎药,双氯芬酸,布洛芬,吲哚美辛,酮洛芬,酮酰基和手术。评估所有英语,前瞻性和回顾性,成人和儿科研究评估用于外科疼痛的静脉内或肌肉内CI NSAIDS,以纳入本综述。结果:鉴定了二十四个预期和回顾性出版物评估CI NSAID:12腹部手术,7中的骨科手术7,以及儿科手术。使用的特异性CI NSAIDs包括双氯芬酸,吲哚美辛,酮丙烯和酮洛克。大多数研究将CI NSAID与安慰剂或替代镇痛药和评估的疼痛对照,补充阿片类药物使用以及相关的不良反应。在这些手术群体中,CI NSAIDS减少了阿片类药物消费,以及提供足够的疼痛控制。虽然很少收集长期不良反应,但使用CI nSAID组经常看到恶心和镇静的降低。结论:在腹部,骨科和儿科外科手术中,CI NSAID代表围手术期疼痛控制的可行替代方式。

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