脊柱手术中神经外科患者的疼痛管理:历史和新模式概述

Ashley M. Carter, Samantha Yost, Jessica Tobin, Simran Phuyal, Brandon Lucke-Wold
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引用次数: 0

摘要

阿片类药物具有强效止痛作用,但代价也很高昂。阿片类药物的成瘾性和副作用引起了人们对脊柱手术后疼痛管理的严重关切。脊柱手术后通常会伴随急性剧烈疼痛,这给最佳康复带来了巨大挑战。本文回顾了脊柱手术疼痛管理的历史方法,并阐述了可减少成瘾性的替代品和新型药物的使用。此外,本文还展示了除认知行为疗法(CBT)、物理疗法和经皮神经电刺激(TENS)等药物治疗方法之外的个性化多模式术后疼痛管理策略。鉴于全球阿片类药物成瘾危机,人们越来越需要从根本上转向更安全有效的替代品。在脊柱手术中超越以阿片类药物为中心的做法,可以优化疼痛缓解,同时改善患者预后并最大限度地降低风险。
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Pain management for the neurosurgical patient in spinal procedures: overview of historic and new modalities
The potent pain-relieving properties of opioids come at a steep price. Their addictive nature and side effects raise critical concerns in managing pain after surgical spine procedures. Postoperatively, spinal surgeries often accompany acute intense pain, which presents a significant challenge in optimal recovery. This paper reviews the historical approach to pain management in spine surgeries and expands on the use of alternatives and novel agents with reduced addictive potential. Additionally showcasing individualized multimodal strategies for postoperative pain management beyond pharmacological approaches such as cognitive behavioral therapy (CBT), physical therapy, and transcutaneous electrical nerve stimulation (TENS). Given the global opioid addiction crisis, there is a growing need for a fundamental shift towards safer and effective alternatives. Transitioning beyond opioid-centric practices in spinal surgery can optimize pain relief while improving patient outcomes and minimizing risk.
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