超前镇痛的研究现状及在临床麻醉中的应用
摘要
<正>已知术中疼痛干扰了手术正常进行,而术后疼痛严重影响患者术后机能的恢复。超前镇痛是在疼痛出现前予以预防性治疗,旨在手术创伤前阻断疼痛传导通路,减轻术中痛,解除患者术后疼痛,改善患者的生活质量。传统意义上的超前镇痛是,在手术之前就应用镇痛药等镇痛措施,以达到术后镇痛的目的。当今,超前镇痛的概念有所延伸,就镇痛时间而言,Kissin~([1])提出,超前镇痛应覆盖术前、术中和术后的每个阶段,达到更好的镇痛效果。本
引文
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[2]Latremoliere A,Woolf C J.Central sensitization:agenerator of pain hypersensitivity by central neural plasticity[J].Pain,2009,10(9):895-926.
[3]Binhas M,Marty J.Systemic analgesia for postoperative pain management in the adult[J].J Chir(Paris),2009,146(1):15-23.
[4]You H J,Lei J,Huang L,et al.Endogenous descending modulation:spatiotemporal effect of dynamic imbalance between descending facilitation and inhibition of nociception[J].J Physiol,2010,588(3):4177-4188.
[5]Lei J,Sun T,Lumb B M,et al.Roles of the periaqueductal gray in descending facilitatory and inhibitory controls of intramuscular hypertonic saline induced muscle nociception[J].Exp Neurol,2014,257(5):88-94.
[6]Chen Y K,Lei J,Jin L,et al.Dynamic variations of c-Fos expression in the spinal cord exposed to intramuscular hypertonic saline induced muscle nociception[J].Eur J Pain,2013,17(3):336-346.
[7]Lei J,You H J.Endogenous descending facilitation and inhibition differ in control of formalin intramuscularly induced persistent muscle nociception[J].Exp Neurol,2013,248(3):100-111.
[8]You H J,Lei J,Ye G,et al.Inflluence of intramuscular heat stimulation on endogenous modulation of nociception:complex role of central different subtypes of opioid receptors in descending facilitation and inhibition[J].J Physiol,2014,592(3):757-773.
[9]You H J,Lei J,Xiao Y,et al.Pre-emptive analgesia and its supraspinal mechanisms:Enhanced descending inhibition and decreased descending facilitation by dexmedetomidine[J].J Physiol,2016,594(7):1875-1890.
[10]黄敏贞,唐群杰.枸橼酸舒芬太尼超前镇痛经静脉患者自控镇痛模式用于烧伤小儿清创植皮术的镇痛效果及安全性的临床观察[J].黑龙江医学,2017,41(7):677-678.
[11]康宇,李丹.关节腔内注射盐酸吗啡酮在膝关节镜手术术后镇痛中的临床应用[J].国际麻醉学与复苏杂志,2016,23(3):4-6.
[12]Selcuk S,Api M,Polat M,et al Effectiveness of local anesthetic on postoperative pain in different levels of laparoscopic gynecological surgery[J].Arch Gynecol Obstet,2015,404(7):15-17.
[13]Gadek A,Liszka H.Premptive local anesthetic infiltration in hallux valgus one-day surgery[J].Przegl Lek,2015,72(1):16-19.
[14]陈燕勤.氟比洛芬酯超前镇痛在腰椎后路融合术术后镇痛中的应用[J].浙江实用医学,2018,29(1):29-31.
[15]张惠艳,董慧领.右美托咪啶复合地塞米松超前镇痛在食管手术中的应用.[J].中国医学创新,2014,42(13):45-46.
[16]Sigh H,Kundra S,Singh R M,et al.Premmptive analgesia with ketamine for laparoscopic cholecystectomy[J].J Anaesthesiol Clin Pharmacol,2013,29(4):478-484.