ERAS術後多模式疼痛治療

ERAS Guidelines on Multimodal Analgesia for Postoperative Pain

根據統計，超過八成以上接受手術的病患於術後被疼痛問題所困擾，而這其中約75％的病人，有中重度等級以上的疼痛。普遍而言能於術後得到合適疼痛處置的情況不到一半，術後疼痛控制不佳除了影響術後生活品質與功能性的回復之外，也會增加術後整體的併發症和術後持續性疼痛的問題。多模式術後疼痛治療，已經被證實能提供效果良好又安全的止痛照護。臨床醫護人員除了依據臨床指引，也必須考量病患的特性與術式量身制定，此術後疼痛計畫須涵蓋術前的評估與衛教，同時搭配藥物與介入性止痛方式，再由醫院組織政策來配合與流程優化，更進一步將照護延伸至病患出院，才能發揮最大功效。 More than 80% of patients who undergo surgical procedures experience acute postoperative pain and approximately 75% of those with post-operative pain report the severity as moderate, severe, or extreme. Evidence suggests that less than half of patients who undergo surgery report adequate postoperative pain relief. Inadequately controlled pain negatively affects quality of life, function, and functional recovery, the risk of post-surgical complications, and the risk of persistent postsurgical pain. Evidence supports the use of multimodal analgesia in many situations, although the exact components of effective multi-modal care will be dependent on the patient, setting, and surgical procedure. A complete pain management plan of care tailored to the individual and the surgical procedure including preoperative education, perioperative pain management planning, use of different pharmacological and nonpharmacological modalities, organizational policies, and transition to outpatient care.