【医脉通】中国肿瘤患者围术期疼痛管理专家共识（2020版）.pdfVIP

中国肿瘤临床2020年第47卷第14期 ChinJClinOncol2020.Vol.47.No.14 703 指南与共识 · · 中国肿瘤患者围术期疼痛管理专家共识（2020版） 中国抗癌协会肿瘤麻醉与镇痛专业委员会 摘要 肿瘤切除术是绝大多数早中期实体肿瘤治疗的基础，肿瘤切除术后常伴随持续的疼痛。手术创伤和疼痛可引起炎症、下 丘脑-垂体轴激活和交感系统过度反应发生。这些因素会影响肿瘤患者的免疫能力，导致免疫抑制。围术期有效的疼痛管理可 以优化肿瘤患者的免疫功能，对肿瘤患者术后康复也具有重要意义。因此，中国抗癌协会肿瘤麻醉与镇痛专业委员会组织专家 制定我国肿瘤患者围术期疼痛管理的专家共识，目的是为肿瘤患者术后急性疼痛管理提供基于证据的临床建议。本共识为学术 性建议，仅限于指导肿瘤患者术后急性疼痛管理，不适用慢性疼痛或肿瘤导致的癌性疼痛。 关键词 专家共识 围术期疼痛管理 抗肿瘤免疫 镇痛药物 doi:10.3969/j.issn.1000-8179.2020.14.584 Consensus on the perioperative pain management of cancer patients in China (2020 edition) The Society of Oncological Anesthesia and Analgesia, Chinese Anti-Cancer Association Correspondence to: Guonian Wang; E-mail: wangguonian609cn@ Abstract Surgical tumor excision is a cornerstone of primary cancer treatment, and persistent postoperative pain is common after most surgical procedures. Surgical trauma and pain can cause inflammation, hypothalamic-pituitary axis activation, and sympathetic system over-reactivity. These factors, acting either separately or in combination, affect anti-tumor immunity and promote postopera- tive immunosuppression. Effective management of perioperative pain may help to modulate the unwanted consequences of the stress response on the immune system and improve outcomes. Based on the recent literature and clinical studies, experts from The Society of Oncological Anesthesia and Analgesia, Chinese Anti-Cancer Association have developed this consensus on the perioperative pain management of cancer patients in China (2020 edition). This consensus aims to provide evidence-based clinical recommendations for the acute pain management of cancer patients postoperatively. It does not apply to chronic pain or pain caused by cancer. Keywords: expert consensus, perioperative pain management, antitumor immunity, a