{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:32:42Z","timestamp":1760574762769,"version":"build-2065373602"},"reference-count":75,"publisher":"Akademiai Kiado Zrt.","issue":"26","license":[{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2025,6,29]]},"abstract":"<jats:p>A m\u00e1j- \u00e9s epe\u00fatseb\u00e9szeti, valamint a hasny\u00e1lmirigym\u0171t\u00e9tek komplex beavatkoz\u00e1sok,\n                    amelyek jelent\u0151s perioperat\u00edv f\u00e1jdalommal j\u00e1rnak. A megfelel\u0151\n                    f\u00e1jdalomcsillap\u00edt\u00e1s nemcsak a beteg komfortj\u00e1t jav\u00edtja, hanem hozz\u00e1j\u00e1rul a\n                    gyorsabb fel\u00e9p\u00fcl\u00e9shez, \u00e9s cs\u00f6kkenti a posztoperat\u00edv sz\u00f6v\u0151dm\u00e9nyek kock\u00e1zat\u00e1t. B\u00e1r\n                    a thoracalis epiduralis analgesia hagyom\u00e1nyosan els\u0151 vonalbeli v\u00e1laszt\u00e1s a\n                    hasny\u00e1lmirigy nyitott m\u0171t\u00e9teihez, alkalmaz\u00e1sa a m\u00e1jseb\u00e9szet ter\u00fclet\u00e9n sok\u00e1ig\n                    vitatott volt. A vonatkoz\u00f3 tapasztalatok b\u0151v\u00fclnek, \u00e9s nagyobb figyelmet kapnak\n                    az alternat\u00edv region\u00e1lis \u00e9s neuraxi\u00e1lis technik\u00e1k. C\u00e9lunk az irodalomban\n                    el\u00e9rhet\u0151 randomiz\u00e1lt, kontroll\u00e1lt vizsg\u00e1latok szisztematikus \u00e1ttekint\u00e9se a\n                    hepatopancreatobiliaris m\u0171t\u00e9tek sor\u00e1n alkalmazott neuraxi\u00e1lis \u00e9s region\u00e1lis\n                    analgesi\u00e1s technik\u00e1kr\u00f3l. C\u00e9lzott keres\u00e9st v\u00e9gezt\u00fcnk a PubMed<jats:sup>\u00ae<\/jats:sup>\n                    adatb\u00e1zisban a hepatopancreatobiliaris m\u0171t\u00e9tekhez alkalmazott region\u00e1lis \u00e9s\n                    neuraxi\u00e1lis \u00e9rz\u00e9stelen\u00edt\u00e9si modalit\u00e1sokra vonatkoz\u00f3an. Keres\u00e9s\u00fcnk ut\u00e1n 47\n                    randomiz\u00e1lt, kontroll\u00e1lt vizsg\u00e1latot elemezt\u00fcnk. Az epiduralis analgesia\n                    tov\u00e1bbra is kiemelked\u0151 f\u00e1jdalomcsillap\u00edt\u00e1st biztos\u00edt, azonban megn\u00f6vekedett\n                    hipotenzi\u00f3- \u00e9s vazopresszorig\u00e9nnyel j\u00e1r. Az intrathecalis morfin alkalmaz\u00e1sa\n                    hat\u00e9kony alternat\u00edva lehet, k\u00fcl\u00f6n\u00f6sen laparoszk\u00f3pos m\u0171t\u00e9tek eset\u00e9n, b\u00e1r fokozott\n                    viszket\u00e9s \u00e9s posztoperat\u00edv h\u00e1nyinger t\u00e1rsulhat hozz\u00e1. A perif\u00e9ri\u00e1s idegblok\u00e1dok,\n                    mint az erector spinae \u00e9s a transversus abdominis s\u00edk blokkok, szignifik\u00e1nsan\n                    cs\u00f6kkenthetik az opioidig\u00e9nyt \u00e9s a mell\u00e9khat\u00e1sokat, az epiduralis technik\u00e1khoz\n                    k\u00e9pest azonban korl\u00e1tozottabb analgetikus hat\u00e1ssal b\u00edrnak. A quadratus lumborum\n                    blokk \u00e9s a paravertebralis blokk alkalmaz\u00e1s\u00e1nak eredm\u00e9nyei heterog\u00e9nek,\n                    hat\u00e9konys\u00e1guk m\u00e9g nem bizony\u00edtott egy\u00e9rtelm\u0171en. A seb\u00e9szi sebinfiltr\u00e1l\u00f3\n                    kat\u00e9terek haszn\u00e1lata egyre elterjedtebb, \u00e9s hat\u00e9kony opioidmegtakar\u00edt\u00f3 hat\u00e1ssal\n                    rendelkezhet. Az optim\u00e1lis m\u00f3dszer kiv\u00e1laszt\u00e1sa multidiszciplin\u00e1ris\n                    d\u00f6nt\u00e9shozatalt ig\u00e9nyel, figyelembe v\u00e9ve a beteg egy\u00e9ni kock\u00e1zati t\u00e9nyez\u0151it \u00e9s a\n                    m\u00e1ra eszk\u00f6zt\u00e1r\u00e1ban jelent\u0151sen gazdagodott m\u0171t\u00e9ti technik\u00e1t. Orv Hetil. 2025;\n                    166(26): 1003\u20131016.<\/jats:p>","DOI":"10.1556\/650.2025.33314","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:09:05Z","timestamp":1751242145000},"page":"1003-1016","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["A region\u00e1lis f\u00e1jdalomcsillap\u00edt\u00e1s m\u00f3dszerei a hepatopancreatobiliaris m\u0171t\u00e9tek \u00e9rz\u00e9stelen\u00edt\u00e9se sor\u00e1n"],"prefix":"10.1556","volume":"166","author":[{"given":"B\u00e1nk","family":"Keczer","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bal\u00e1zs","family":"Varga","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"Sz\u00e9ll","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attila","family":"Szij\u00e1rt\u00f3","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katalin","family":"Darvas","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcell","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti, Transzplant\u00e1ci\u00f3s \u00e9s Gasztroenterol\u00f3giai Klinika Budapest, \u00dcll\u0151i \u00fat 78., 1082 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","unstructured":"1 European Cancer Information System. 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