国际麻醉学与复苏杂志   2023, Issue (8): 0-0
    
区域阻滞麻醉后反跳痛的研究进展
王刚, 马浩南, 王国林1()
1.天津市泰达医院
Research progress of rebound pain after regional anesthesia
 全文:
摘要:

【摘要】 区域阻滞麻醉(Regional anesthesia ,RA)是多模式麻醉和镇痛策略的重要组成部分,能最大限度地减少阿片类药物的消耗。然而,RA后反跳痛是一种不良反应,可能影响整体效果。其疼痛强度对患者心理健康、康复质量和日常活动等方面都具有重要的临床意义。目前的证据表明,反跳痛代表了在缺乏足够的全身镇痛的情况下预期伤害性反应的暴露情况。本文总结了已发表的关于反跳痛的发生、影响和预防的文献,为RA术后急性疼痛的管理提供参考。减轻反跳痛的策略包括全身多模式镇痛方案、向患者适当宣教有关区域阻滞麻醉消退后预期的术后疼痛,使用持续导管技术及局麻药辅助剂延长RA的作用时间。然而这些策略的实施细节和效果评估需要更深入的研究来证实。

关键词: 区域麻醉;反跳痛;术后疼痛;多模式镇痛;术后镇痛;
Abstract:

【Abstract】 Regional anesthesia (RA) is an essential component of multimodal anesthesia and analgesia, which helps reduce opioid consumption. However, rebound pain after RA can compromise its overall benefits. The intensity of pain has significant clinical implications for patients' mental health, rehabilitation quality, and daily activities. According to current evidence, rebound pain is an unmasking of the expected nociceptive response due to inadequate systemic analgesia. In this review, we examined published literature on the occurrence, effects, and prevention of rebound pain after peripheral nerve blocks in patients to provide insights into the management of acute pain after RA surgery. Strategies to alleviate rebound pain include systemic multimodal analgesia, appropriate patient education, and preemptive analgesia before block. Additionally, the continuous catheter technique and the use of local anesthetic adjuvants to prolong the action time of RA may help relieve rebound pain. However, further studies are necessary to confirm the effectiveness of these approaches.

Key words: Regional anesthesia; Rebound pain; Postoperative pain; Multimodal analgesia; Postoperative analgesia