无背景输注术后镇痛的临床应用

Clinical Application of Postoperative Analgesia without Background Infusion Dose

摘要: 研究显示，外科手术后由于创伤等刺激，患者出现手术后疼痛的几率为95%以上，疼痛刺激对机体的确具有一部分自我保护作用，然而不可否认的是，疼痛对于机体的不利作用更甚，术后疼痛作为一种伤害性刺激可对患者造成一系列的不利影响，无论是心理还是生理方面，既导致术后各种并发症的发生，更甚者可能会对患者产生严重的心理疾病。因此，术后镇痛变得尤为重要。自控镇痛因其具有起效较快、用药个体化、患者满意度高等优点，是目前手术后镇痛最常用和最理想的方法，普遍应用于术后镇痛。阿片类药物因其镇痛效果强大，是术后镇痛的常用药物。但由于阿片药物的副作用，患者不同程度的存在恶心呕吐、呼吸抑制等不良反应。无背景剂量输注作为镇痛泵设置的另一种模式，逐渐应用于对术后镇痛有需求的患者中。本文检索大量相关文献，就无背景输注模式在不同手术中的应用进行归纳总结，目的是为有术后镇痛需求的患者围术期选择更合适的镇痛输注模式提供相关参考。

Abstract: The research results show that the incidence of postoperative pain is more than 95% due to trauma and other stimuli after surgery. Pain stimulation does have a part of self-protection effect on the body, but it is undeniable that the adverse effect of pain on the body is more serious. Postoperative pain, as a kind of harmful stimulation, can cause a series of adverse effects on patients. Whether it is psychological or physiological, it can lead to a variety of postoperative complications, and even may produce serious psychological diseases for patients. Therefore, postoperative analgesia becomes particularly important. Self-controlled analgesia is the most commonly used and ideal method for postoperative analgesia due to its advantages of rapid onset, individualized medication and high patient satisfaction. Opioids are commonly used for postoperative analgesia because of their powerful analgesic effect. However, due to the side effects of opioids, patients have different degrees of nausea, vomiting, respiratory depression and other adverse reactions. Non-background dose infusion is increasingly being used as an alternative mode of analgesic pump setup in patients who need postoperative analgesia. In this paper, a large number of relevant literatures were searched to summarize the application of non-background infusion mode in different surgeries, with the purpose of providing relevant reference for selecting a more appropriate analgesic infusion mode in perioperative period for patients with postoperative analgesia needs.