术后疼痛管理的进展(双语).pptx

Management of Postoperative Pain;Pharmacological Options药理选项; Acetaminophen 对乙酰氨基酚 Acetaminophen (Paracetamol) is an effective analgesic for mild to moderate pain with favorable side effect profile. 对乙酰氨基酚(扑热息痛)是一种对于轻度至中度疼痛有效的镇痛药，并且副作用轻。 analysis of analgesic efficacy suggested that acetaminophen and tramadol is an effective analgesic combination in dental and post surgical pain. However, more patients experienced side effects like dizziness, nausea and vomiting with this combination 分析镇痛效果，建议对于牙科和手术后疼痛对乙酰氨基酚和曲马朵是一种有效的止痛剂组合。然而,这种组合更多的患者出现副作用,如头晕、恶心、呕吐。 iv acetaminophen, commonly used in Europe, has the flexibility of being able to be used in the perioperative period and may be a viable alternative to NSAIDs in minor surgery and a useful adjunct in conjunction with other analgesics. 静脉使用对乙酰氨基酚,常用在欧洲,,能够被灵活用于围手术期处理，在小手术中可替代非甾体类抗炎药,也可结合其他镇痛药使用。 ;Non-Steroidal Anti-inflammatory Drugs and Cyclo-oxygenase (COX-2) Inhibitors非甾体抗炎药和环氧化酶(cox - 2)抑制剂;;;;Ketamine 氯胺酮;There is ample evidence to suggest that ketamine has opioid sparing effect and may confer advantage in patients. where large amount of postoperative opioid consumption is anticipated. At low doses ketamine can provide analgesia in opioid resistant pain.??Continuous infusion of ketamine has been used perioperatively. 有充分的证据表明, 使用氯胺酮可节约阿片类药物的用量，当预期术后将有大量的阿片类药物使用时，可能有利于病人。低剂量氯胺酮对阿片类药物抵抗的疼痛可提供镇痛。持续输注氯胺酮已应用在围手术期。 These drugs have to be used with caution in the ambulatory setting due to its potential side effects including sedation and hallucinatory effects. in some individuals, though administering only a bolus dose and avoiding the infusion regimen can reduce the incidence of adverse events. 对于门诊病人，这些药物必须小心使用，由于其潜在的副作用,包括镇静和致幻作用。对于某些病人, 使用一个单次剂量并避免持续输注可以减少不良事件的发生率。 ;Wound infiltration with local anesthetics伤口渗入与局部麻醉剂;Intra-articular analgesics关节内的止痛剂;Peripheral Nerve Blocks (PNB)外周神经阻滞;;Other Pharmacological and Non-Pharmacological Options其他药理和后备选项;;Rationale for multimodal analge