地塞米松在围手术期疼痛管理中的研究进展

Progress in research on the application of Dexamethasone in perioperative pain management

术后疼痛是指手术后即刻发生的急性疼痛,是由于手术刺激使神经末梢释放大量炎性递质,兴奋伤害性感受器导致的炎性疼痛,属于伤害性疼痛的一种。疼痛现已成为继体温、脉搏、呼吸、血压之后的第5生命体征。有效的围手术期疼痛管理不仅能减轻患者术后疼痛,提高患者舒适度,还能加速患者康复进程。地塞米松具有抗炎、降低痛觉中枢敏化,减轻术后恶心呕吐等作用,在围手术期疼痛管理中扮演重要角色。地塞米松可以通过不同给药途径发挥镇痛作用,然而,目前对于地塞米松的最佳给药方式、给药时间以及对特定人群产生的镇痛效果仍然存在较大争议。现就地塞米松在围手术期疼痛管理中的最新进展进行综述,以供临床参考。

Postoperative pain refers to the acute pain that occurs immediately after surgery.It is caused by the surgical stimulation of nerve endings,leading to the release of a large number of inflammatory transmitters and stimulation of nociceptive receptors,which belongs to a type of nociceptive pain.Pain has now become recognized as the fifth vital sign after temperature,pulse,respiration and blood pressure.Effective perioperative pain management can not only reduce postoperative pain and improve patient comfort but also accelerate the recovery process of patients.Dexamethasone plays an important role in perioperative pain management due to its anti-inflammatory effect,reduction of central sensitization of pain,and alleviation of postoperative nausea and vomiting.Dexamethasone can play an analgesic role through different routes of administration.However,there are still significant controversies about the best administration method,administration time and analgesic effect of dexamethasone in specific populations.This article reviews the latest progress on dexamethasone in perioperative pain management for clinical reference.