加强老年结直肠癌患者术后恢复的多模式镇痛策略

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY Pain and Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-05 DOI:10.1007/s40122-024-00619-0
Li Huang, Tianhao Zhang, Kaixin Wang, Bingcheng Chang, Daan Fu, Xiangdong Chen
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引用次数: 0

摘要

术后恢复强化方案(ERAS)在缩短老年人结直肠癌手术休养时间和减轻术后不良反应方面的优点已得到充分证明。尽管如此,术后疼痛控制这一关键环节并没有得到应有的重视。通常情况下,将非甾体类抗炎药、阿片类药物、局部麻醉药和神经阻滞等多种镇痛疗法结合在一起使用,对于减少手术并发症和缩短住院期间的康复时间至关重要。然而,这种综合止痛策略并非没有隐患;器官功能障碍的阴影笼罩着老年群体,其根源在于镇痛药的滥用或多种药物的复杂相互作用。革命性的研究正在深入探讨替代性给药和释放模式,力求减轻镇痛的意外后果,从而提高老年结直肠癌术后人群的术后疗效。本综述通过比较多模式镇痛方案的既有益处和潜在局限性,探讨了多模式镇痛方案的双重性,并深入分析了不断发展的给药和释放策略。
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Postoperative Multimodal Analgesia Strategy for Enhanced Recovery After Surgery in Elderly Colorectal Cancer Patients.

Enhanced Recovery After Surgery (ERAS) protocols have substantially proven their merit in diminishing recuperation durations and mitigating postoperative adverse events in geriatric populations undergoing colorectal cancer procedures. Despite this, the pivotal aspect of postoperative pain control has not garnered the commensurate attention it deserves. Typically, employing a multimodal analgesia regimen that weaves together nonsteroidal anti-inflammatory drugs, opioids, local anesthetics, and nerve blocks stands paramount in curtailing surgical complications and facilitating reduced convalescence within hospital confines. Nevertheless, this integrative pain strategy is not devoid of pitfalls; the specter of organ dysfunction looms over the geriatric cohort, rooted in the abuse of analgesics or the complex interplay of polypharmacy. Revolutionary research is delving into alternative delivery and release modalities, seeking to allay the inadvertent consequences of analgesia and thereby potentially elevating postoperative outcomes for the elderly post-colorectal cancer surgery populace. This review examines the dual aspects of multimodal analgesia regimens by comparing their established benefits with potential limitations and offers insight into the evolving strategies of drug administration and release.

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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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