下肢血管疾病患者的围术期疼痛管理进展  

Progress of perioperative pain management in patients with lower limb vascular diseases

作　　者：王霞[1] 吴洲鹏[2] WANG Xia;WU Zhoupeng(Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Division of Vascular Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院麻醉手术中心,成都610041 [2]四川大学华西医院普通外科血管外科病房,成都610041

出　　处：《中国普外基础与临床杂志》2024年第4期508-512,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结目前下肢血管疾病患者的围术期疼痛管理进展。方法复习近年来国内外有关下肢血管疾病患者的围术期疼痛管理的文献并进行综述。结果下肢血管疾病在老年患者中十分常见,不管是肢体缺血性疼痛还是手术相关的疼痛,往往会加重患者应激反应,不利于此类患者的康复。良好的镇痛管理对于此类患者十分重要。围术期疼痛管理可以采用静脉给予镇痛药物、口服镇痛药物、局部麻醉、椎管内阻滞、外周神经阻滞等方法。围术期需积极处理患者的急慢性疼痛,建议尽可能采取预防性镇痛策略。结论良好的围术期镇痛管理很有必要。通过采用一种或多种镇痛方法来最大程度地缓解下肢血管疾病患者的疼痛、恢复肢体功能和提高生活质量。Objective To summarize the progress of perioperative pain management in patients with lower limb vascular diseases.Method Retrieved the literature about pain management in patients with lower limb vascular diseases both at home and abroad in recent years and reviewed the literature.Results Lower limb vascular diseases were very common in elderly patients.Whether it was limb ischemic pain or surgery-related pain,it often increased the stress response and activation of the autonomic system,which was not conducive to the recovery of the disease.Good analgesic management was important for these patients.Perioperative pain management could be performed by intravenous analgesics,oral analgesics,local anesthesia,neuraxial anesthesia and peripheral nerve block.Acute and chronic pain should be actively managed during perioperative period.Pre-emptive analgesic strategies could be implemented in patients with severe peripheral vascular disease.Conclusions Good perioperative analgesia management is necessary.Pain management which employes one or more analgesic methods is important in maximizing pain relief,function,and quality of life for this patient group.

关 键 词：下肢血管疾病 围术期 疼痛管理 

分 类 号：R614[医药卫生—麻醉学]