■过度使用麻醉药品后,会出现高死亡率和化学物质依赖性,这些药物的处方已成为医疗保健的中心讨论。减少阿片类药物处方的努力包括增强手术后恢复(ERAS)指南,其中描述了局部麻醉技术,以减少或消除阿片类药物在综合方案中使用时的需求。这里,我们回顾了有效的围手术期阻滞,以减少乳房再造手术后阿片类药物的使用.
■使用关键词麻醉品进行了全面审查,阿片类药物手术,乳房重建,疼痛泵,神经阻滞,区域麻醉,和镇痛。论文描述了用于乳房重建的局部麻醉选择,以减少术后麻醉剂的消耗,用英语写的,包括在内。
■这篇综述共包括52篇论文。局部麻醉选择包括单次神经阻滞,神经阻滞导管,以及局部和区域麻醉。大多数论文报道了相同或甚至更好的疼痛控制与减少恶心和呕吐,住院时间,和其他结果。
虽然阿片类药物目前是手术后疼痛管理的黄金标准药物,减少处方阿片类药物剂量或数量的策略可能会导致更好的患者结局.使用局部麻醉技术已被证明可以减少麻醉药的使用并改善乳房重建手术后患者的疼痛评分。
BACKGROUND: High rates of mortality and chemical dependence occur following the overuse of narcotic medications, and the prescription of these medications has become a central discussion in health care. Efforts to curtail opioid prescribing include Enhanced Recovery After Surgery (ERAS) guidelines, which describe local anesthesia techniques to decrease or eliminate the need for opioids when used in a comprehensive protocol. Here, we review effective perioperative blocks for the decreased use of opioid medications post-breast reconstruction surgery.
METHODS: A comprehensive review was conducted using keywords narcotics, opioid, surgery, breast reconstruction, pain pump, nerve block, regional anesthesia, and analgesia. Papers that described a local anesthetic option for breast reconstruction for decreasing postoperative narcotic consumption, written in English, were included.
RESULTS: A total of 52 papers were included in this review. Local anesthetic options included single-shot nerve blocks, nerve block catheters, and local and regional anesthesia. Most papers reported equal or even superior pain control with decreased nausea and vomiting, length of hospital stay, and other outcomes.
CONCLUSIONS: Though opioid medications are currently the gold standard medication for pain management following surgery, strategies to decrease the dose or number of opioids prescribed may lead to better patient outcomes. The use of a local anesthetic technique has been shown to reduce narcotic use and improve patients\' pain scores after breast reconstruction surgery.