海洛因成癮者手術全期之疼痛照護

The Perioperative Management of Pain in Patients Who Are Addicted to Heroin

Heroin成癮者入院手術時，即應被視為高風險疼痛病人看待，因其於治療期間將會面對複雜的疼痛管理，且可能會發生嚴重的戒斷症狀。醫療照護人員本身對於海洛因成癮、止痛的鴉片類藥物的認知不足，以及擔心給予鴉片類藥物後會再次觸發病人海洛因成癮行為等等，可能使得海洛因成癮者於住院手術期間缺乏適當的疼痛管理。本文旨在說明海洛因成癮者的手術全期之疼痛照護，包含海洛因之身心效應、手術造成疼痛之機轉、海洛因成癮與手術全期疼痛之關係、臨床處置及護理，期望能協助醫護人員認識海洛因成癮病人的手術全期之疼痛照護，以提升病人手術全期之疼痛的照護品質與安全。

Heroin addicts admitted to the hospital for surgery should be treated as high-risk patients because these patients face a significantly higher risk of experiencing severe drug withdrawal symptoms and of pain management complications during hospitalization. The lack of proper pain management often suffered by heroin addicts during hospitalization has been attributed to care providers' insufficient knowledge regarding opioid medications and their addicting effects as well as fears that opioid medications may cause addiction symptoms to reemerge. The objective of this article is to illustrate the pain management process across the entire hospitalization period for heroin-addicted patients undergoing surgical procedures. This process includes management of the heroin-related physical and psychological reactions from surgery, of the mechanism of pain induced specifically from surgery, and of the heroin addiction during the surgical procedure and subsequent clinical management and nursing care. It is hoped that this article assists healthcare providers to better understand the need for the proper pain management and care of heroin-addicted surgical patients over the entire period of hospitalization and thus the enhancement of the overall quality and safety of patient care management procedures.