CAJ | 학술논문

背景阿片类药物是术后镇痛的主要药物,但长期使用阿片类药物的患者因对阿片类药物产生耐受而难以得到较理想的临床术后镇痛效果.目的讨论如何采用不同的镇痛技术和药物来更好地为这些患者提供良好镇痛.内容介绍阿片类药物依赖的流行病学及术后镇痛特点,如何对阿片类药物依赖规范合理使用阿片类药物及辅助类镇痛药物,麻醉医生擅长的神经阻滞技术在该类患者应有独特的地位.趋向在阿片类药物依赖患者,通过使用阿片类药物、局麻药和辅助性镇痛药,将不同作用机制的药物或方法联合使用,发挥药物的相加或协同作用的平衡镇痛及多模式镇痛将是术后镇痛技术的主要发展方向.
배경 아편류약물시술후진통적주요약물,단장기사용아편류약물적환자인대아편류약물산생내수이난이득도교이상적림상술후진통효과.목적 토론여하채용불동적진통기술화약물래경호지위저사환자제공량호진통.내용 개소아편류약물의뢰적류행병학급술후진통특점,여하대아편류약물의뢰규범합리사용아편류약물급보조류진통약물,마취의생천장적신경조체기술재해류환자응유독특적지위.추향 재아편류약물의뢰환자,통과사용아편류약물、국마약화보조성진통약,장불동작용궤제적약물혹방법연합사용,발휘약물적상가혹협동작용적평형진통급다모식진통장시술후진통기술적주요발전방향.
Background Opioids are the main drugs for managing postoperative pain. Patients with chronic opioidconsuming would experience more intense postoperative pain because of opioids-tolerance property. Purpose This review will discuss how to provide adequate postoperative analgesia for these patients by optimizing of opioids, adjuvant medications and regional anesthetic techniques. Content This review will introduce the epidemiology of opioid dependence patients and their characteristics of postoperative analgesia, and how to regulate the rational using of opioid analgesics and nonopioid analgesic techniques in opioid dependence patients with specification. Nerve block technique which anesthesiologists are familiar with should occupy a unique position in these patients. Trend Multimodal analgesia or balanced analgesia by using of opioids, local anesthetics and adjuvant analgesics drugs with different mechanisms or methods will be the main development direction in postoperative pain management,which used in combination will play a balanced additive or synergistic analgesia effects in opioid dependent patients.