课件：围术期镇痛挑战与思考麻醉科.pptVIP

* 250 patients who had undergone surgical procedures (in- and outpatient) in the past year completed a questionnaire about their experiences with pain before and after surgery. The most common concern that patients expressed prior to surgery was experiencing pain (59%), which was cited more often than concerns about whether the surgery would improve their condition (51%) or whether they would fully recover (46%). 58% of the sample reported pain prior to surgery. Despite receiving treatment for pain, 82% reported pain in the immediate postsurgical period (end of surgery up to 2 weeks after discharge) and 75% reported pain after discharge. More than two thirds of patients reported pain of moderate to severe intensity, and extreme pain was reported by 18% overall and 8% after discharge. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97:534-540. * There are many ways to effectively treat acute and chronic pain. Each of these options offers its own benefits and risks. No single option is right for every patient.  NOTE: for more information on treatment options, see: Kehlet H, Dahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg. 1993;77:1048-1056. * Opioid analgesics are generally considered a “gold standard” for analgesic efficacy, but physician and patient concerns about their potential side effects may actually contribute to the global problem of the undermanagement of pain.1-3 References: 1. Moreland LW, St. Clair EW. The use of analgesics in the management of pain in rheumatic diseases. Rheum Dis Clin North Am. 1999;25:153-191. 2. Atcheson R, Rowbotham DJ. Pharmacology of acute and chronic pain. In: Rawal N, ed. Management of Acute and Chronic Pain. London, England: BMJ Books; 1998:23-50. 3. Power I, Barratt S. Analgesic agents for the postoperative period. Nonopioids. Surg Clin No