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心脏手术后的慢性术后疼痛:一项叙述性综述。

Chronic postsurgical pain after cardiac surgery: A narrative review.

作者信息

Dost Burhan, Karapinar Yunus Emre, Karakaya Deniz, Demir Zeliha Asli, Baris Sibel, Koksal Ersin, Aydin Muhammed E, Ciftci Bahadir, Tulgar Serkan

机构信息

Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Türkiye.

Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Türkiye.

出版信息

Saudi J Anaesth. 2025 Apr-Jun;19(2):181-189. doi: 10.4103/sja.sja_829_24. Epub 2025 Mar 25.

Abstract

Chronic postsurgical pain (CPSP) is a prevalent and debilitating sequela of cardiac surgery, exerting a profound impact on patients' quality of life, functional recovery, and healthcare systems. Its pathophysiology includes complex mechanisms, including peripheral and central sensitization, neuroplastic alterations, and inflammatory pathways, influenced by demographic, psychological, and perioperative factors. Inadequate management of acute pain is a critical contributor to its development. This review examines the etiology of CPSP, presents key risk factors, and critically evaluates pharmacological and nonpharmacological interventions. Particular attention is devoted to the role of regional anesthesia techniques and emerging preventive and therapeutic strategies, highlighting the necessity of multidisciplinary, evidence-informed approaches to address this persistent clinical challenge.

摘要

慢性术后疼痛(CPSP)是心脏手术常见且使人衰弱的后遗症,对患者的生活质量、功能恢复及医疗系统产生深远影响。其病理生理学包括复杂机制,如外周和中枢敏化、神经可塑性改变及炎症途径,受人口统计学、心理学和围手术期因素影响。急性疼痛管理不当是其发生的关键因素。本综述探讨了CPSP的病因,介绍了关键危险因素,并对药物和非药物干预进行了批判性评估。特别关注区域麻醉技术的作用以及新兴的预防和治疗策略,强调采用多学科、循证方法应对这一持续性临床挑战的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7802/12007855/c7caeb6da414/SJA-19-181-g001.jpg

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