2019冠状病毒病时期慢性疼痛治疗的实用建议：聚焦介入技术的叙述性综述
Practical Advices for Treating Chronic Pain in the Time of COVID-19: A Narrative Review Focusing on Interventional Techniques.
作者信息
Lo Bianco Giuliano, Papa Alfonso, Schatman Michael E, Tinnirello Andrea, Terranova Gaetano, Leoni Matteo Luigi Giuseppe, Shapiro Hannah, Mercadante Sebastiano
机构信息
Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy.
Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, 90015 Cefalù, Italy.
出版信息
J Clin Med. 2021 May 25;10(11):2303. doi: 10.3390/jcm10112303.
BACKGROUND
Since the management of chronic pain has become even more challenging secondary to the occurrence of SARS-CoV-2 outbreaks, we developed an exhaustive narrative review of the scientific literature, providing practical advices regarding the management of chronic pain in patients with suspected, presumed, or confirmed SARS-CoV-2 infection. We focused particularly on interventional procedures, where physicians are in closer contact with patients.
METHODS
Narrative Review of the most relevant articles published between June and December of 2020 that focused on the treatment of chronic pain in COVID-19 patients.
RESULTS
Careful triage of patients is mandatory in order to avoid overcrowding of hospital spaces. Telemedicine could represent a promising tool to replace in-person visits and as a screening tool prior to admitting patients to hospitals. Opioid medications can affect the immune response, and therefore, care should be taken prior to initiating new treatments and increasing dosages. Epidural steroids should be avoided or limited to the lowest effective dose. Non urgent interventional procedures such as spinal cord stimulation and intrathecal pumps should be postponed. The use of personal protective equipment and disinfectants represent an important component of the strategy to prevent viral spread to operators and cross-infection between patients due to the SARS-CoV-2 outbreaks.
背景
由于新型冠状病毒肺炎疫情的爆发，慢性疼痛的管理变得更具挑战性，我们对科学文献进行了详尽的叙述性综述，就疑似、推定或确诊新型冠状病毒感染患者的慢性疼痛管理提供实用建议。我们特别关注介入性操作，因为在这些操作中医生与患者有更密切的接触。
方法
对2020年6月至12月发表的最相关文章进行叙述性综述，这些文章聚焦于新冠病毒感染患者的慢性疼痛治疗。
结果
必须对患者进行仔细分诊，以避免医院空间过度拥挤。远程医疗可能是一种有前景的工具，可替代面对面就诊，并作为患者入院前的筛查工具。阿片类药物会影响免疫反应，因此，在开始新治疗和增加剂量之前应谨慎。应避免使用硬膜外类固醇，或限制在最低有效剂量。非紧急的介入性操作，如脊髓刺激和鞘内泵治疗应推迟。由于新型冠状病毒肺炎疫情，使用个人防护设备和消毒剂是防止病毒传播给操作人员以及患者之间交叉感染策略的重要组成部分。
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