腹腔镜胆囊切除术后疼痛管理--非阿片类药物方法:综述

IF 3.4 Q2 PHARMACOLOGY & PHARMACY Future Journal of Pharmaceutical Sciences Pub Date : 2024-09-16 DOI:10.1186/s43094-024-00697-z
Hoda Mohamed Bayoumi, Doaa Hamed Abdelaziz, Nouran Omar El Said, Sherif Boraii, Ehab Rasmy Bendas
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引用次数: 0

摘要

背景胆石症及其后果是一种常见的临床问题,可能需要手术切除。与传统的开腹手术相比,腹腔镜胆囊切除术(LC)仍是治疗无症状胆石症的主要方法,可缩短恢复期和住院时间,但可能会出现严重的腹部和肩部疼痛。正文为了改善患者护理,对腹腔镜胆囊切除术后急性和慢性疼痛管理的新型药物和技术进行了研究。本综述讨论了腹腔镜手术中使用非阿片类药物的创新疼痛管理策略,重点是确保患者快速、安全地康复。结论主要研究结果表明,静脉注射扑热息痛是多模式术后疼痛管理的必要组成部分。研究还发现了几种有效控制疼痛的药物干预方法:硫酸镁和地塞米松具有抗炎作用;昂丹司琼具有镇痛效果;加巴喷丁类和α-2-激动剂可降低中枢敏感性;局部麻醉剂可有针对性地缓解疼痛;抗抑郁剂可缓解神经性疼痛;非甾体抗炎药对炎症性疼痛有效。同样,非药物治疗方法和新兴技术也有助于治疗 LC 术后疼痛,这说明需要采取综合方法来治疗疼痛。需要更严格的研究来指导 LC 后的疼痛治疗。未来的研究应同时比较多种治疗方法,并让更多患者参与其中。这种方法将有助于确定最佳疼痛控制策略。它还将使人们更清楚地了解各种止痛药物在可比临床条件下的安全性和有效性。
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Postoperative pain management following laparoscopic cholecystectomy-non-opioid approaches: a review

Background

Gallstone disease with its consequences is a common clinical issue that may necessitate surgical removal. In comparison with traditional open procedures, laparoscopic cholecystectomy (LC) remains the mainstay treatment for symptomatic gallstone disease and can lead to a shorter recovery period, and a shorter hospital stay; yet, severe abdominal and shoulder pain may be experienced.

Main body

Novel drugs and technology for acute and chronic pain management following LC have been studied to improve patient care. The review discusses innovative pain management strategies with non-opioid approaches for laparoscopic surgery, with an emphasis on ensuring speedy and safe recovery.

Conclusion

The key findings state that IV paracetamol is a necessary part of multimodal postoperative pain management. There were several pharmacological interventions found to be effective in pain control: magnesium sulfate and dexamethasone showed anti-inflammatory benefits; ondansetron provided analgesic effects; gabapentinoids and alpha-2-agonists reduced central sensitization; local anesthetics offered targeted pain relief; antidepressants addressed neuropathic pain; NSAIDs proved effective for inflammatory pain. Similarly, non-pharmacological approaches, and emerging technologies, also contributed to the management of post-LC pain underscoring the need for a comprehensive approach to its management. More rigorous research is needed to guide pain management after LC. Future studies should compare multiple treatments simultaneously and involve larger patient groups. This approach will help identify optimal pain control strategies. It will also provide clearer insights into the safety and efficacy of various pain medications under comparable clinical conditions.

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来源期刊
自引率
0.00%
发文量
44
审稿时长
23 weeks
期刊介绍: Future Journal of Pharmaceutical Sciences (FJPS) is the official journal of the Future University in Egypt. It is a peer-reviewed, open access journal which publishes original research articles, review articles and case studies on all aspects of pharmaceutical sciences and technologies, pharmacy practice and related clinical aspects, and pharmacy education. The journal publishes articles covering developments in drug absorption and metabolism, pharmacokinetics and dynamics, drug delivery systems, drug targeting and nano-technology. It also covers development of new systems, methods and techniques in pharmacy education and practice. The scope of the journal also extends to cover advancements in toxicology, cell and molecular biology, biomedical research, clinical and pharmaceutical microbiology, pharmaceutical biotechnology, medicinal chemistry, phytochemistry and nutraceuticals.
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