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The role of regional analgesia in personalized postoperative pain management

대한마취과학회지 2020년 73권 5호 p.363 ~ 371
Chitnis Shruti S., Tang Raymond, Mariano Edward R.,
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 ( Chitnis Shruti S. ) - University of British Columbia Vancouver General Hospital Department of Anesthesiology and Perioperative Care
 ( Tang Raymond ) - University of British Columbia Vancouver General Hospital Department of Anesthesiology and Perioperative Care
 ( Mariano Edward R. ) - Stanford University School of Medicine Department of Anesthesiology, Perioperative and Pain Medicine

Abstract


Pain management plays a fundamental role in enhanced recovery after surgery pathways. The concept of multimodal analgesia in providing a balanced and effective approach to perioperative pain management is widely accepted and practiced, with regional anesthesia playing a pivotal role. Nerve block techniques can be utilized to achieve the goals of enhanced recovery, whether it be the resolution of ileus or time to mobilization. However, the recent expansion in the number and types of nerve block approaches can be daunting for general anesthesiologists. Which is the most appropriate regional technique to choose, and what skills and infrastructure are required for its implementation? A multidisciplinary team-based approach for defining the goals is essential, based on each patient's needs, and incorporating patient, surgical, and social factors. This review provides a framework for a personalized approach to postoperative pain management with an emphasis on regional anesthesia techniques.

키워드

Acute pain; Enhanced recovery; Multimodal analgesia; Nerve block; Opioid; Pain management; Persistent postsurgical pain; Personalized medicine; Postoperative pain; Regional anesthesia

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