围术期非阿片类镇痛药的应用进展  

Application Progress of Non-opioid Analgesics in Perioperative Period

作　　者：李峰 沈通桃 LI Feng;SHEN Tong-tao(Department of Anesthesiology,Taizhou Second People's Hospital,Yangzhou University School of Medicine,Taizhou,Jiangsu Province,225500 China;Department of Anesthesiology,Affiliated Hospital of Yangzhou University(Yangzhou First People's Hospital),Yangzhou,Jiangsu Province,225012 China)

机构地区：[1]扬州大学医学院附属泰州市第二人民医院麻醉科,江苏泰州225500 [2]扬州大学附属医院(扬州市第一人民医院)麻醉科,江苏扬州225012

出　　处：《系统医学》2021年第2期195-198,共4页Systems Medicine

摘　　要：手术为抢救与治疗患者的常用手段,但其属于有创治疗方式,易引发强烈疼痛感。阿片类药物在临床手术治疗中被广泛应用,可发挥较好的镇痛功效,但其易引发多种不良反应,且大剂量用药易致急性耐受与痛觉过敏,进而导致患者出现更为严重的疼痛反应。为提升镇痛治疗的可靠性与安全性,多种非阿片类药物以及新型镇痛技术在临床上逐渐得到应用,以促使患者机体疼痛感减轻,并使阿片类药物的应用减少,避免相关不良反应发生。该文就综述目前临床上围术期应用的主要几种非阿片类镇痛药(艾司氯胺酮、加巴喷丁类药物、利多卡因、α2受体激动剂、NSAIDs)的效果与安全性,使非阿片类镇痛药能够得到更为合理的应用,以期使患者围术期疼痛管理工作更为精确高效,在保障患者围术期镇痛效果的同时,避免过度应用镇痛药物,将镇痛药物相关不良反应减少,同时节约医疗药物资源。Surgery is a common method for rescuing and treating patients,but it is an invasive treatment method that easily causes intense pain.Opioids are widely used in clinical surgical treatments and can exert better analgesic effects,but they are prone to cause a variety of adverse reactions,and high-dose medications are prone to acute tolerance and hyperalgesia,which can lead to more severe symptoms in patients.In order to improve the reliability and safety of analgesic treatment,a variety of non-opioid drugs and new analgesic technologies are gradually being applied in clinical practice to reduce the pain in the patient's body and reduce the use of opioids to avoid related adverse effects.This article reviews the effects and safety of several major non-opioid analgesics(esketamine,gabapentin,lidocaine,α2 receptor agonists,NSAIDs)currently used clinically in the perioperative period.Class analgesics can be used more reasonably,in order to make the patient's perioperative pain management more accurate and efficient,while ensuring the patient's perioperative analgesic effect,avoid excessive application of analgesic drugs,and reduce related analgesic drugs adverse reactions,while saving medical drug resources.

关 键 词：手术 围术期 阿片类药物 非阿片类药物 镇痛 不良反应 

分 类 号：R44[医药卫生—诊断学]