开颅手术后疼痛管理的研究进展

开颅手术是最常见的神经外科手术之一。开颅术后中重度疼痛发生率高达75%,术后疼痛可增加术后并发症，延长ICU停留时间和住院时间，严重影响患者术后康复。部分镇痛方法和镇痛药物导致的恶心、呕吐、呼吸抑制等不良反应可能会影响患者术后的神经功能，掩盖神经系统症状，干扰病情判断，目前尚无针对开颅患者的确切镇痛方案。如何实施开颅患者术后镇痛，改善患者转归，成为临床亟待解决的问题。本文就开颅术后疼痛特点、疼痛机制、疼痛评估、镇痛策略与管理进行综述，以期为开颅手术的术后镇痛提供参考。

Research progress in pain management after craniotomy

Craniotomy is one of the most common neurosurgical operations. The incidence of moderate and severe pain after craniotomy is as high as 75%. Pain after craniotomy can increase postoperative complications and prolong ICU stay and hospitalization time, which seriously affects patients'' postoperative recovery. Adverse reactions such as nausea, vomiting, and respiratory depression caused by some analgesic precedures and drugs may affect the postoperative neurological function of patients, which cover up the symptoms of nervous system, and interfere with the judgment of the condition. At present, there is no exact analgesic regimen for craniotomy patients. How to relieve pain after craniotomy and improve the outcome of patients has become an urgent clinical problem. This article reviews the characteristics, mechanism, evaluation, strategies and management of postoperative pain after craniotomy, in order to provide reference for postoperative analgesia after craniotomy.