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| 神经外科术后急性疼痛管理的研究进展 |
| Advances in acute pain management after neurosurgery |
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| DOI：10.12089/jca.2026.01.017 |
| 中文关键词: 神经外科 术后急性疼痛 多模式镇痛 疼痛管理 |
| 英文关键词: Neurosurgery Postoperative acute pain Multimodal analgesia Pain management |
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| 中文摘要: |
| 超过50%的神经外科手术患者会在术后48 h内经历中度至重度的术后急性疼痛，却往往得不到有效镇痛，增加术后病残率，延长住院时间，甚至严重影响术后康复。安全有效且不影响术后专科检查的术后镇痛是神经外科患者术后早期活动和快速康复的重要前提。传统阿片类药物的镇痛方式虽然有效，但是常导致恶心呕吐等不良反应。围术期多模式镇痛能有效控制疼痛已成为共识，目前临床上不断探索多种非阿片类药物和辅助镇痛技术在神经外科术后镇痛的应用价值。本文通过介绍神经外科术后急性疼痛的发生机制，总结非阿片类药物、神经阻滞以及局部浸润麻醉等在术后疼痛管理中的研究进展，以期为临床平衡镇痛效果与药物不良反应风险提供参考。 |
| 英文摘要: |
| Within 48 hours after surgery, more than half of neurosurgery patients will experience moderate to severe acute postoperative pain, which is often not effectively controlled, increasing postoperative disability, prolonging hospitalization, and even seriously affecting patients' postoperative recovery. Safe and effective postoperative analgesia that does not interfere with postoperative specialized examinations is an important prerequisite for early postoperative activity and rapid recovery of neurosurgery patients. Traditional opioid analgesia is effective but often brings side effects such as nausea and vomiting. It has become a consensus that perioperative multimodal analgesia is effective in controlling pain, and the value of multiple non-opioid drugs and adjuvant analgesic techniques in neurosurgical postoperative analgesia has been continuously explored in clinical practice. This review discusses the mechanisms underlying acute postoperative pain in neurosurgery and summarizes the advancements in postoperative pain management using non-opioid medications, nerve blocks, and local infiltration anesthesia. The aim is to provide effective analgesic strategies for clinical practice, balancing pain relief with the risk of adverse drug reactions. |
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