老年肿瘤患者开胸手术术后镇痛研究进展

开胸手术对老年肿瘤患者创伤巨大,术后的疼痛可诱发机体的一系列不良反应,同时限制了患者肺功能的恢复.目前国内外已有多种方法用于肿瘤患者开胸手术术后镇痛,例如静脉镇痛、硬膜外镇痛、椎旁神经阻滞、肋间神经阻滞、肋间神经冰冻法、胸膜间镇痛、鞘内注射吗啡镇痛等,其各有适应症、禁忌症和不良反应.胸段胸膜外镇痛和阿片类药物联合应用是目前开胸手术后镇痛的金标准,多模式镇痛是主要发展趋势.

Research progress of postoperaive analgesia in elderly patients with cancer after thoracotomy

Thoracotomy has great trauma for elderly cancer patients.Postoperative pain can induce a series of adverse reactions in the body and limit the recovery of pulmonary function in patients.At present,many methods have been used to ease the pain after thoracotomy in elderly patients,such as intravenous analgesia,epidural analgesia,paravertebral block,intercostal nerve block,cryoanalgesia,interpleural block and intrathecal morphine.Each kind of analgesic methods has indications,contraindications and adverse reactions.The combination of epidural analgesia and opioid drugs is the gold standard for analgesia after thoracotomy and multimodal analgesia is the main trend of development.