手部软组织手术患者口服抗凝治疗的无阿片类药物疼痛管理策略

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2025-09-12 DOI:10.1016/j.jhsa.2025.07.020

Ellis M Berns, Thompson Zhuang, Hannah H Lee

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引用次数: 0

摘要

非麻醉性多模态镇痛已成为手部软组织手术患者的标准。这些治疗方案通常包括非甾体抗炎药，如酮罗拉酸和布洛芬，它们会增加抗凝治疗患者出血的风险。本综述旨在(1)阐明与非甾体类抗炎药和抗凝药相关的凝血生理学，(2)检查目前关于抗凝患者有限时间使用非甾体类抗炎药的风险和益处的外科文献，(3)确定可行的疼痛管理替代方案，(4)强调抗凝患者非阿片类镇痛需要进一步研究的领域。

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Opioid-Free Pain Management Strategies for Patients on Oral Anticoagulation Undergoing Soft Tissue Hand Surgery.

Non-narcotic multimodal analgesia has become standard for patients undergoing soft tissue hand surgery. These regimens often include nonsteroidal anti-inflammatory drugs such as ketorolac and ibuprofen, which can elevate bleeding risks in patients on anticoagulation therapy. This review aims to (1) elucidate the physiology of coagulation in relation to nonsteroidal anti-inflammatory drugs and anticoagulants, (2) examine the current surgical literature on risks and benefits of limited-duration nonsteroidal anti-inflammatory drug use in anticoagulated patients, (3) identify viable pain management alternatives, and (4) highlight areas warranting further research in nonopioid analgesia for anticoagulated patients.

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.