从多模式全身麻醉谈平衡麻醉的少阿片化趋势  

Multimodal general anesthesia with opioid-sparing mode

作　　者：吴云[1] 韩伟 王鹏磊 张野[1] WU Yun;HAN Wei;WANG Penglei;ZHANG Ye(Department of Anesthesiology and Perioperative Medicine,Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院麻醉与围术期医学科,安徽合肥230601

出　　处：《麻醉安全与质控》2021年第6期319-323,共5页Perioperative Safety and Quality Assurance

基　　金：国家自然科学基金(81900316)。

摘　　要：阿片类药物以其强效的镇痛效应在外科手术的“平衡麻醉”中发挥着举足轻重的作用。这把双刃剑在缓解疼痛的同时,也带来了恶心、呕吐、呼吸抑制等不良反应;而药物滥用、成瘾依然是不可回避的社会问题。多模式全身麻醉是针对伤害性感受环路中的不同目标选择特异的抗伤害性药物,以小剂量药物协同作用发挥最大效应,同时减少药物各自的不良反应。因此,通过右美托咪定、非甾体类抗炎药等药物以及神经阻滞等技术方法或将实现少阿片化的多模式全身麻醉,成为围术期主要的镇痛模式。Opioids play an important role in balanced anesthesia with their potent analgesic effect.However,this double-edged sword also brings nausea,vomiting,respiratory depression and other adverse reactions.Meanwhile,drug abuse and addiction are still unavoidable social problems.Multimodal general anesthesia relies on agents with specific central nervous system targets such as dexmedetomidine,nonsteroidal anti-inflammatory drugs as well as nerve block techniques.It is postulated that use of more agents at smaller doses further maximizes desired effects while minimizing side effects of opioid.Multimodal general anesthesia with opioid-sparing mode is expected to be the main analgesic method in perioperative period in the future.

关 键 词：多模式全身麻醉 少阿片化 多模式镇痛 

分 类 号：R614[医药卫生—麻醉学]