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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Brief review: Perioperative management of the patient with chronic non-cancer pain: (Article de synthese court : Prise en charge perioperatoire des patients souffrant de douleur chronique non cancereuse).
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Brief review: Perioperative management of the patient with chronic non-cancer pain: (Article de synthese court : Prise en charge perioperatoire des patients souffrant de douleur chronique non cancereuse).

机译：简要评论：慢性非癌性疼痛患者的围手术期管理：（简短评论文章：慢性非癌性疼痛患者的围手术期管理）。

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PURPOSE: Both opioid and non-opioid medications are being utilized increasingly in the treatment of chronic non-cancer pain, and the number of surgical patients receiving large regular doses of opioids is ever-expanding. The perioperative pain control of these patients is often challenging, and is broadening the role of the anesthesiologist as 'perioperative physician'. These patients need to be identified before surgery to plan optimal pain control postoperatively. The purpose of this review is to provide an update on the important considerations in managing the chronic non-cancer pain patient receiving high dose opioids and other adjunctive medications/analgesics. SOURCE: English language articles published between June 1980 and May 2006 were identified by a computerized Medline search using keywords (1/2)chronic pain(1/2), (1/2)opioid dependent(1/2) and (1/2)perioperative(1/2). This same search strategy was repeated and updated using both Medline and Embase. All relevant publications were retrieved and their bibliographies were scanned for additional sources. PRINCIPAL FINDINGS: Although an increasingly common problem for the acute pain service, there is very little published on this topic. Key points include the concept of opioid equivalency, tolerance, the role of adjunctive medications, and the need for good communication between the surgical team, the acute pain service and the patient who is often anxious about the upcoming procedure due to previous unpleasant experiences with poor pain control in hospital. CONCLUSION: Clinical care of the opioid-dependent patient in the perioperative period can be a daunting task. Education to all staff involved in this area needs to be enhanced to improve outcome and patient satisfaction.
机译：目的：阿片类药物和非阿片类药物在治疗慢性非癌性疼痛方面正得到越来越多的使用，接受大剂量常规阿片类药物的外科手术患者的人数正在不断增加。这些患者的围手术期疼痛控制通常具有挑战性，并且正在扩大麻醉医师作为“围手术期医师”的作用。这些患者需要在手术前确定，以计划术后的最佳疼痛控制。这篇综述的目的是提供有关在管理接受高剂量阿片类药物和其他辅助药物/镇痛药的慢性非癌性疼痛患者治疗中重要考虑因素的最新信息。资料来源：1980年6月至2006年5月之间发表的英语文章通过计算机Medline搜索确定，使用关键词（1/2）慢性疼痛（1/2），（1/2）阿片类药物依赖性（1/2）和（1 / 2）围手术期（1/2）。使用Medline和Embase重复并更新了相同的搜索策略。检索了所有相关出版物，并对其书目进行了扫描以查找其他来源。主要发现：尽管急性疼痛治疗的问题日益普遍，但有关该主题的文献很少。关键点包括阿片类药物等效性的概念，耐受性，辅助药物的作用以及外科团队，急性疼痛服务人员与患者之间的良好沟通需求，这些患者由于先前的不良经历而感到焦虑，常常对即将到来的手术感到焦虑在医院控制疼痛。结论：阿片类药物依赖患者围手术期的临床护理可能是一项艰巨的任务。需要加强对该领域所有人员的教育，以提高结果和患者满意度。

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