无阿片药麻醉临床应用进展  

Clinic advanced of opioid-free anesthesia

作　　者：刘元雪 李峰 王艺丹 郭其发 沈通桃[3] Liu Yuanxue;Li Feng;Wang Yidan;Guo Qifa;Shen Tongtao(Department of Anesthesiology,Affiliated Yizheng People's Hospital,Medical School of Yangzhou University,Yizheng 211400,China;Department of Anesthesiology,Affiliated Taizhou Second Hospital,Medical School of Yangzhou University,Taizhou 225500,China;Department of Anesthesiology,Affiliated Hospital of Yangzhou University,Yangzhou 225001,China)

机构地区：[1]扬州大学医学院附属仪征人民医院麻醉科,211400 [2]扬州大学医学院附属泰州第二医院麻醉科,225500 [3]扬州大学附属医院麻醉科,225001

出　　处：《国际麻醉学与复苏杂志》2021年第5期505-509,共5页International Journal of Anesthesiology and Resuscitation

摘　　要：随着对阿片药认识的不断加深和加速康复外科(enhanced recovery after surgery,ERAS)的发展,无阿片药麻醉(opioid-free anesthesia,OFA)在临床应用越来越多。OFA是基于多模式麻醉理念,通过相关药物和/或方法来提供一个无阿片药的优质全身麻醉。许多病例报道和研究显示OFA安全可行,并可减少阿片药相关副作用。文章就OFA的概念、OFA的优势、OFA的适应证、相关药物选择(如右美托咪定、氯胺酮、利多卡因、硫酸镁、非甾体抗炎药等)及麻醉方法进行综述。OFA作为一种新的麻醉样式,其更多的益处和对患者近远期的影响有待观察,临床常规应用还存在一定争议。With the growth of the understanding of opioids and the improvement of enhanced recovery after surgery(ERAS),more and more patients have been used opioid-free anesthesia(OFA).OFA is multimodal anesthesia associating drugs and/or techniques that allow a good quality general anesthesia with no need for opioids.Some case reports and studies are showing that OFA is feasible and safe and decreases the risk of common opioid-relative adverse effects.This article reviews the definite,benefits and indications of OFA,selection of analgesic drugs(dexmedetomidine,ketamine,lidocaine,magnesium sulfate,anti-inflammatory drugs,etc),and methods of anesthesia.OFA as a new paradigm,there is a need for more research on benefits and both early and long-term outcome after surgery.To support the clinic routine use of OFA has still a debate.

关 键 词：麻醉药 阿片类 非阿片 手术 麻醉 

分 类 号：R614[医药卫生—麻醉学]