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Present-day challenges and future solutions in postoperative pain management: results from PainForum 2014

机译:术后疼痛管理的当前挑战和未来解决方案:PainForum 2014的结果

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摘要

This paper is a summary of presentations on postoperative pain control by the authors at the 2014 PainForum meeting in People’s Republic of China. Postoperative pain is often untreated or undertreated and may lead to subsequent chronic pain syndromes. As more procedures migrate to the outpatient setting, postoperative pain control will become increasingly more challenging. Evidence-based guidelines for postoperative pain control recommend pain assessment using validated tools on a consistent basis. In this regard, consistency may be more important than the specific tool selected. Many hospitals have introduced a multidisciplinary acute pain service (APS), which has been associated with improved patient satisfaction and fewer adverse events. Patient education is an important component of postoperative pain control, which may be most effective when clinicians chose a multimodal approach, such as paracetamol (acetaminophen) and opioids. Opioids are a mainstay of postoperative pain control but require careful monitoring and management of side effects, such as nausea, vomiting, dizziness, and somnolence. Opioids may be administered using patient-controlled analgesia systems. Protocols for postoperative pain control can be very helpful to establish benchmarks for pain management and assure that clinicians adhere to evidence-based standards. The future of postoperative pain control around the world will likely involve more and better established APSs and greater communication between patients and clinicians about postoperative pain. The changes necessary to implement and move forward with APSs is not a single step but rather one of continuous improvement and ongoing change.
机译:本文是在2014年中国PainForum会议上作者对术后疼痛控制的介绍的摘要。术后疼痛通常未经治疗或未得到充分治疗,并可能导致随后的慢性疼痛综合症。随着越来越多的程序转移到门诊,术后疼痛控制将变得越来越具有挑战性。术后疼痛控制的循证指南建议使用经过验证的工具在一致的基础上进行疼痛评估。在这方面,一致性可能比所选的特定工具更为重要。许多医院已经引入了多学科的急性疼痛服务(APS),与患者满意度的提高和不良事件的减少相关。对患者的教育是术后疼痛控制的重要组成部分,当临床医生选择对乙酰氨基酚(对乙酰氨基酚)和阿片类药物等多模式方法时,这可能是最有效的。阿片类药物是术后疼痛控制的主要手段,但需要仔细监测和管理副作用,例如恶心,呕吐,头晕和嗜睡。阿片类药物可以使用患者控制的镇痛系统进行给药。术后疼痛控制方案对于建立疼痛管理基准并确保临床医生遵守循证标准非常有帮助。全世界范围内术后疼痛控制的未来将可能涉及更多和更好地建立的APS,以及患者和临床医生之间关于术后疼痛的更多交流。实施和推进APS所需的更改不是一步,而是持续改进和不断变化的步骤之一。

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