胸腔移植术后疼痛管理。

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY Current Opinion in Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-07-31 DOI:10.1097/ACO.0000000000001418
Clara Lobo, Boris Tufegdzic
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引用次数: 0

摘要

回顾的目的:心肺移植的发展具有重要的里程碑意义。克里斯蒂安-巴纳德(Christiaan Barnard)博士于 1967 年成功进行了首次心脏移植,随后布鲁斯-雷茨(Bruce Reitz)、诺曼-沙姆韦(Norman Shumway)和乔尔-库珀(Joel Cooper)博士在心肺和单肺移植方面取得了进展,为当代器官移植奠定了基础,为终末期心肺疾病患者带来了希望:最近的研究结果:心脏移植受者在移植前使用阿片类药物与较高的死亡率和移植后对阿片类药物的依赖有关。有效的疼痛控制对于减少阿片类药物相关不良反应和促进康复至关重要。然而,针对心脏移植受者的特定疼痛管理方案的研究却很有限。在肺移植中,有效的疼痛控制至关重要。研究强调了多模式策略(包括胸硬膜外镇痛和胸椎旁阻滞)对促进康复和减少阿片类药物使用的益处。肺移植围手术期疼痛控制的挑战是独特的,需要仔细考虑以预防并发症和改善预后。摘要:本综述强调了对心脏和肺移植受者进行量身定制的疼痛管理的重要性。它提倡延长随访时间和使用替代镇痛药,以尽量减少阿片类药物依赖性并提高生活质量。需要进一步开展高质量的研究,以优化术后镇痛并改善患者预后。
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Postoperative pain management after thoracic transplantations.

Purpose of review: Heart and lung transplantation evolution marked significant milestones. Pioneering efforts of Dr Christiaan Barnard with the first successful heart transplant in 1967, followed by advancements in heart-lung and single-lung transplants by Drs Bruce Reitz, Norman Shumway, and Joel Cooper laid the groundwork for contemporary organ transplantation, offering hope for patients with end-stage heart and pulmonary diseases.

Recent findings: Pretransplant opioid use in heart transplant recipients is linked to higher mortality and opioid dependence posttransplant. Effective pain control is crucial to reduce opioid-related adverse effects and enhance recovery. However, research on specific pain management protocols for heart transplant recipients is limited. In lung transplantation effective pain management is crucial. Studies emphasize the benefits of multimodal strategies, including thoracic epidural analgesia and thoracic paravertebral blocks, to enhance recovery and reduce opioid use. Perioperative pain control challenges in lung transplantation are unique and necessitate careful consideration to prevent complications and improve outcomes.

Summary: This review emphasizes the importance of tailored pain management in heart and lung transplant recipients. It advocates for extended follow-up and alternative analgesics to minimize opioid dependency and enhance quality of life. Further high-quality research is needed to optimize postoperative analgesia and improve patient outcomes.

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来源期刊
CiteScore
4.90
自引率
8.00%
发文量
207
审稿时长
12 months
期刊介绍: ​​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.
期刊最新文献
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