超前镇痛的临床应用研究进展及有效性分析

Analysis on the research progress of clinical application of preemptive analgesia and effectiveness

最有效的术后疼痛治疗应当是预先给药,超前阻止或减轻手术过程中中枢神经的致敏作用以及感受伤害的传人,达到减轻术后疼痛、延长镇痛时间和减少止痛药的需求量。在术后患者自控镇痛时,超前镇痛或预防性镇痛已经成为麻醉师常用的治疗方法。尽管国内外对于超前镇痛临床有效性的结论尚未统一,采取有效措施预防手术伤害性刺激引起外周及中枢敏化的理念已得到公认,且有关超前镇痛的基础和临床研究仍在继续并日趋成熟。如何实施超前镇痛,提高临床镇痛效应。目前尚缺乏超前镇痛临床规范,真实镇痛效果如何尚难以确定。持续和多模式的预防性镇痛是疼痛治疗发展的方向。本文主要对超前镇痛的定义、机制,超前镇痛的常用药物和方法及超前镇痛的争议及规范化进行综述。

The most effective postoperative pain treatment should be administered in advance, advance to prevent or mitigate the central nervous operation in the process of sensitization and afferent nociceptive, to relieve postoperative pain,prolong the time of analgesia and reduce the demand of painkillers. In the postoperative patient controlled analgesia,preemptive analgesia or preventive analgesia has become a commonly used method of treatment the anesthesiologist. Although both at home and abroad for the preemptive analgesia clinical validity of the conclusions have not yet unified, take effective measures to prevent damage caused by stimulation of the peripheral and central sensitization concept has been recognized, and the basic and clinical research about preemptive analgesia continues and more mature. How to implement preemptive analgesia, improve the clinical analgesic effect. The current lack of preemptive analgesia clinical norms, the real effect of analgesia is still difficult to determine how to. Continuous and multi-mode preventive analgesia is the development direction of pain treatment. This paper is mainly on the definition, preemptive analgesia mechanism, commonly used drugs and method of preemptive analgesia and reviewed the advance controversy and specification of analgesia.