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术后疼痛管理是临床麻醉与围手术期医学的核心挑战之一。当前，术后中重度疼痛的发生率依然居高不下，国外一项覆盖包括中国在内10个国家、64家医院、10 415例患者的研究（2017—2019年）显示，以数字评价量表（numerical rating scale，NRS）评分评估，约50%的患者经历了重度疼痛，25%的患者在≥50%的时间里处于剧烈疼痛之中，59%的重度疼痛患者使用了阿片类药物。2023年，我国122家医院26 193例手术患者的多中心调查（中国术后急性疼痛研究）显示，术后中重度疼痛发生率为48.7%，其中重度疼痛占32.2%。 面对这一严峻现状，为改善术后疼痛管理，近年来指南与共识持续更新，新药与新技术不断落地，在这一背景下，江苏省人民医院、郑州大学第一附属医院杨建军教授围绕术后疼痛再认识、2026指南更新、药物前沿以及AI与未来四大核心板块，系统梳理术后镇痛领域的最新进展，以期为临床实践与科研探索提供参考。 专家介绍 杨建军  教授 主任医师，教授，博士研究生导师 江苏省人民医院（南京医科大学第一附属医院）麻醉与围术期医学科主任 郑州大学第一附属医院麻醉与围手术期及疼痛医学部主任 中华医学会麻醉学分会常务委员兼疼痛学组组长、舒适化诊疗建设专项负责人 中国老年医学学会、中国精准医学学会常务理事 中国神经科学学会麻醉与脑功能分会副主任委员 河南省医学会麻醉学分会主任委员 一、术后疼痛再认识与理念革新 1.疼痛的范畴与评估维度 疼痛是一种主观体验，受生物学、心理学及社会环境多重因素影响。疼痛与伤害性感受不同——纯粹生物学意义上的感觉神经元和神经通路的活动并不代表疼痛。个体对自身疼痛的主诉应被接受并尊重；语言描述仅是表达疼痛的方式之一，语言交流障碍不代表无疼痛感受。疼痛通常是适应性和保护性的，但也可对机能、心理和社会功能产生不利影响。 2.急性围术期疼痛管理指导原则 根据2021版急性围手术期疼痛管理的指导原则，临床实践需遵循以下核心要点：进行术前评估，包括评估医疗和心理状况、合并症药物、慢性疼痛史、药物滥用以及以前的术后治疗方案和反应，以指导围手术期疼痛管理计划；使用经过验证的疼痛评估工具来跟踪对术后疼痛治疗的反应并相应地调整治疗计划；提供多模式镇痛，或使用多种镇痛药物和技术结合非药物干预，用于治疗成人术后疼痛；为患者和/或负责的护理人员提供以患者和家庭为中心的个性化教育，包括有关管理术后疼痛的治疗方案信息；向所有患者和主要护理人员提供有关疼痛治疗计划的教育，包括正确储存和处置阿片类药物以及出院后逐渐减少镇痛药用量；根据疼痛缓解的充分性和不良事件的存在调整疼痛管理计划；对于术后疼痛控制不充分或在其设施中术后疼痛控制不充分的患者，可以咨询疼痛专家。 3.镇痛评价的三大转变 当前的疼痛管理效果评价之变，集中体现在三个维度：（1）时间尺度——从单一时点到疼痛轨迹：急性疼痛轨迹（下降速度/持续时间）比某时点疼痛评分更具预后价值。（2）评价情境——从静息痛到活动痛与功能恢复：患者能否早期活动与疼痛控制关系更密切。（3）终点指标——从疼痛强度到患者体验：恢复质量（quality of recovery，QoR）、睡眠、情绪、认知干扰应成为核心终点。三者归一：疼痛评分只是过程指标，功能与体验才是终点指标。 4.最小化阿片类药物与精准多模式镇痛 最小化阿片类药物使用仍是目前疼痛管理趋势。临床倡导多模式镇痛即联合应用两种及以上不同作用机制的镇痛药物或技术，包括局麻药、非甾体抗炎药（non-steroidal anti-inflammatory drugs，NSAIDs）与对乙酰氨基酚、α2肾上腺素能激动剂、N-甲基-D-天冬氨酸（N-methyl-D-aspartate，NMDA）受体拮抗剂、曲马多与他喷他多等。 在此背景下，精准多模式镇痛理念应运而生。该策略需综合考虑术前合并的慢性疼痛、切口痛、内脏痛和炎性痛，实现从“一刀切”向个体化精准多模式镇痛策略的转变。 二、2026指南更新与临床实践规范 1.成人术后疼痛管理临床实践指南（2024版） 中华医学会麻醉学分会疼痛学组发布《成人术后疼痛管理临床实践指南（2024版）》。该指南严格遵循《世界卫生组织指南制订手册》及推荐分级的评估、制定与评价（grading of recommendations assessment, development and evaluation，GRADE）方法学，围绕术前宣教与镇痛管理计划、围术期疼痛评估及组织管理、围术期镇痛管理策略、过渡性疼痛服务四个方面展开。具体临床问题重点涵盖术前疼痛宣教及预康复、术前影响因素、评估工具准确性、急性疼痛服务的影响、预防性镇痛、多模式镇痛优势、对乙酰氨基酚与NSAIDs的效果、周围神经阻滞、椎管内镇痛、静脉镇痛泵配置、节约阿片类药物方案、阿片类药物不良反应、术后爆发痛和反跳痛、基于手术类型的疼痛管理、日间手术及老年患者镇痛方案等。 指南同时剖析了每个临床问题涉及的研究空白（图1），如微视频等新宣教形式、预康复策略、单维与多维评估工具对比、术前鞘内镇痛、精准多模式镇痛理念应用、选择性环氧化酶-2（cyclooxygenase-2，COX-2）抑制剂对比、长效局麻药远期预后、鞘内与硬膜外镇痛比较、偏向性μ受体激动剂及外周高选择性κ受体激动剂应用、过渡性疼痛服务（transitional pain service，TPS）在预防急性疼痛转为慢性疼痛中的作用等。 图1 《成人术后疼痛管理临床实践指南（2024版）》的临床问题与研究空白 2.成年手术患者精准多模式镇痛临床规范 王天龙教授提出“精准多模式镇痛”理念，并于2025年发布了《成年手术患者精准多模式镇痛临床规范》团体标准，该团体标准明确了精准多模式镇痛的临床基本要求、围手术期疼痛评估与干预流程、常用镇痛药物与镇痛技术的应用原则，以及不同部位手术的镇痛方案实施细则。其核心流程包括：（1）术前疼痛预康复：全面采集病史与体格检查，结合术前患者存在的疼痛类型，制定个体化多模式镇痛方案，开展患者教育，缓解焦虑并提升依从性。（2）术中镇痛/抗应激管理的精准监测：术中阿片类药物和镇痛管理的个体化与精准化，可用的监测指标包括末梢灌注指数（TPI）、意识指数（index of consciousness，IoC2）、镇痛指数（PTi）与镇痛/伤害性刺激指数（analgesia nociception index，ANI）等，力求将对伤害性刺激的感知降至最低。（3）术后精准多模式镇痛：综合考虑疼痛来源、手术部位、疼痛应激强度和功能康复需求，选择合适的组合式精准镇痛，以实现对“外科切口痛+炎性痛”“内脏痛+炎性痛”“外科切口痛+内脏痛+炎性痛”三种疼痛模式的有效控制。 该规范对六大类手术（开颅手术、胸科手术、心脏手术、腹部手术、关节置换手术、脊柱手术）从疼痛来源、术前镇痛、麻醉前预防性镇痛、术中镇痛、术后镇痛管理进行了详细阐述。 3.2026 ASA指南核心推荐 2026年，美国麻醉医师协会（American Society of Anesthesiologists，ASA）发布《胸心外科手术、乳腺切除术及腹部手术围术期疼痛管理中局部与区域镇痛应用实践指南》，按术式与患者年龄分层、并结合证据质量对局部与区域镇痛给出分级推荐。核心结论指向筋膜平面阻滞：在哪类手术用什么，指南都给出了明确答案。 成人部分，指南以中等质量证据强推荐（图2）：开放性胸心外科手术、乳腺切除术、腹部手术（含腹膜后及盆腔手术）与微创腹部手术使用筋膜平面阻滞，以减少术后24 h内的疼痛与阿片类药物需求；对微创胸心外科手术与开放性疝修补术，因证据质量较低，仅作有条件推荐——且前者的推荐范围更宽，涵盖椎管内阻滞与筋膜平面阻滞在内的区域镇痛技术。 图2 美国麻醉医师协会2026年指南关于局部与区域镇痛应用的推荐声明汇总 儿童部分（18岁以下）推荐更为谨慎：开放性胸心外科手术以中等质量证据获强推荐，筋膜平面阻滞可减少术后最初24 h内的疼痛与阿片类药物需求；开放性疝修补术仅有低质量证据支持，列为有条件推荐，目标是降低术后24 h的疼痛评分（图3）。 图3 美国麻醉医师协会2026年指南儿童部分（开放性胸心外科手术与开放性疝修补术）的证据汇总 4.PROSPECT指南：基于手术类型的术后疼痛管理 PROSPECT工作组（procedure-specific postoperative pain management，基于手术类型的术后疼痛管理）自2004年首次发布开胸术等特定手术的疼痛管理推荐以来，历经方法学完善期（2006年起）和持续更新与拓展期（2015年至今），实现了从单一术式到多学科围手术期疼痛管理的全面拓展。 2026 PROSPECT乳腺肿瘤大手术后：核心要点是以对乙酰氨基酚、NSAIDs或COX-2抑制剂与地塞米松构成三联基础镇痛；推荐单次周围神经阻滞，可选竖脊肌平面阻滞、胸肌间平面阻滞与胸肌-前锯肌平面阻滞、前锯肌平面阻滞（浅层或深层）、胸椎旁阻滞及伤口局部浸润；术前与术后的物理治疗同样推荐。爆发痛以阿片类药物补救。不推荐常规使用连续胸椎旁阻滞（单次阻滞已足以覆盖急性疼痛轨迹的高峰），不推荐在局麻药中添加可乐定等佐剂，也不推荐常规使用加巴喷丁类药物。 2026 PROSPECT 椎管内麻醉下择期剖宫产术后：核心要点是规律给予对乙酰氨基酚作为多模式镇痛的基础，联合NSAIDs（短期使用安全），胎儿娩出后静脉给予地塞米松8~10 mg；术后镇痛首选鞘内吗啡50~100 μg或二乙酰吗啡≤300 μg，硬膜外吗啡2~3 mg或二乙酰吗啡2~3 mg；若未使用鞘内阿片，则选用腹横肌平面（transversus abdominis plane，TAP）阻滞、腰方肌阻滞（quadratus lumborum block，QLB）、竖脊肌平面阻滞或髂腹股沟-髂腹下神经阻滞，亦可行伤口局部浸润；爆发痛以阿片类药物补救。非药物措施推荐经皮神经电刺激与腹部加压绑带，手术技术推荐Joel-Cohen切口与不缝合腹膜。 2026 PROSPECT 全髋关节置换术后：核心要点为常规使用对乙酰氨基酚作为多模式镇痛的基石；联合NSAIDs或COX-2抑制剂；推荐使用地塞米松（≤10 mg）；必要时给予鞘内吗啡（≤0.1 mg）；优先选择腹股沟上髂筋膜间隙阻滞或术前囊周神经群（pericapsular nerve group，PENG）阻滞；出现爆发痛时使用阿片类药物补救。不推荐腰椎竖脊肌平面阻滞和腰方肌阻滞。 2025 PROSPECT 开胸术后：核心要点是以对乙酰氨基酚联合NSAIDs或COX-2抑制剂作为基础镇痛；一线区域镇痛为胸段硬膜外镇痛或椎旁阻滞，两者镇痛效果相近、可按患者情况与术者条件二选一（椎旁阻滞在术后首日血流动力学更稳定）；二者不可行时，使用竖脊肌平面阻滞、菱形肌肋间阻滞或肋间神经阻滞；无法实施任何区域镇痛时，可考虑针灸或冷冻镇痛。爆发痛以阿片类药物补救。不推荐加巴喷丁类药物与右美托咪定作佐剂，亦不推荐前锯肌平面阻滞与静脉地塞米松（镇痛证据不足）。 三、药物前沿与新型镇痛策略 1.超长效局麻药 布比卡因脂质体已在全球范围内广泛应用，不仅能提供长达3 d的镇痛效果，还能显著减少术后阿片类药物的使用，有效降低恶心、呕吐等不良反应，是术后镇痛管理的经典选择。 缓释罗哌卡因（CZ1S和QP-6211）采用微晶体缓释工艺，通过局部给药形成“药物储库”持续释放，已完成Ⅲ期临床研究，尤其是CZ1S在膝关节置换手术“股神经联合腘动脉与膝关节囊之间浸润阻滞（infiltration between the popliteal artery and capsule of the knee，iPACK）”模式中，充分凸显罗哌卡因运动-感觉分离的优势。YZJT-1705注射液是罗哌卡因的原位凝胶制剂，在给药部位原位形成凝胶储库，药物通过扩散方式从储库缓慢释放。 新型利多卡因制剂可注射缓释利多卡因聚合物溶液，在体内形成软性凝胶储库，实现药物的长效缓慢释放，目前处于Ⅱ期临床试验阶段。具有药物缓释及超声显影功能的罗哌卡因微泡也在研发中。 2.非甾体抗炎药新剂型 美洛昔康注射液：采用纳米晶型技术，能够迅速达到有效血药浓度，4.8 min达峰、6 min起效，作用持续可达24 h。一项192例腹部手术患者的多中心、随机、双盲、安慰剂对照研究显示：主要疗效指标SPID24（0~24 h疼痛强度差总和，sum of pain intensity difference，SPID）显著优于对照组，补救镇痛的患者比例与次数也远低于对照组，阿片类药物补救用量相较于对照组减少了61.4%。此外，胃肠道不良事件发生率低于传统NSAIDs。 口服速释美洛昔康（Mr-107A-02）：解决了传统口服美洛昔康给药后起效延迟的问题。与安慰剂组相比，SPID0~48 h的疼痛强度降低幅度显著更大，且起效更快、可感知且具有临床意义的疼痛缓解效果更佳，同时阿片类补救用药用量显著减少，其阿片类药物相关不良事件发生率低于曲马多。 右酮洛芬氨丁三醇为非选择性环氧化酶抑制剂，去除“无效且可能有害”的左旋体，在等效镇痛剂量下仅需消旋体一半的用量，其起效迅速，在急诊、日间手术及口腔外科中均展现出快速强效、补救率低；大型骨科手术吗啡用量减少约39%。常用注射类非甾体抗炎药多维度对比见图4。 图4 常用注射用非甾体抗炎药的多维度比较 3.偏向性μ受体激动剂 阿片类药物的镇痛作用与不良反应是由两个不同的信号通路所介导：G蛋白通路主要与镇痛作用有关，引发部分不良反应；β-抑制蛋白通路主要与呼吸、消化道等不良反应有关。传统μ受体激动剂（如吗啡、芬太尼、氢吗啡酮）等效激活上述通路。偏向性μ受体激动剂能够选择性激活G蛋白信号通路，显著减少对β-抑制蛋白通路的激活，在保留镇痛效力的同时，显著减少而非消除阿片相关不良反应。目前国内临床可及的两个代表药物是泰吉利定与奥赛利定。 泰吉利定：与吗啡对比（中国Ⅲ期临床），镇痛效果与吗啡相当，部分时点镇痛效果更优；安全性优势显著，胃肠道不适、呼吸抑制等阿片类药物传统风险显著降低，耐受性更好。与舒芬太尼对比（老年直肠癌患者），镇痛效果相当，术后胃肠功能显著改善——术后胃肠功能障碍（postoperative gastrointestinal dysfunction，POGD）发生率大幅降低；总体不良事件发生率显著降低。与羟考酮对比（子宫切除术），镇痛效果相当，术后恶心呕吐（postoperative nausea and vomiting，PONV）风险显著降低；总体不良反应发生率更低。 奥赛利定：与舒芬太尼相比，呼吸抑制与PONV风险显著降低52%，术后24 h的15项恢复质量（15-item quality of recovery，QoR-15）评分更高，镇痛疗效相当。与吗啡相比，总体相对危险度（relative risk，RR）=0.80（0.1 mg组0.58），恶心风险降低逾40%；呕吐RR=0.55（0.1 mg组0.39），降幅逾60%。在老年胸腔镜肺手术患者中，以术后3 d内每日平均咳嗽NRS评分＜4分、且每日最高PONV评分＜2分定义的镇痛满意且恶心呕吐最轻（satisfactory analgesia with minimal emesis，SAME）比例，奥赛利定组为46.3%，高于舒芬太尼组的32.3%，恶心呕吐更少，术后1、2 d咳嗽NRS与QoR-15均更优，下床更早、补救镇痛更少。 4.突破性机制与新靶点药物 阿片类药物危机促使人们迫切寻找非阿片类镇痛药。电压门控钠通道（voltage-gated sodium channels，VGSCs）在痛觉感觉神经元的兴奋与冲动传导中起关键作用，其中NaV1.8主要分布于外周初级感觉神经元、不参与中枢神经活动，因而成为近年镇痛药物研发的热点。2025年美国批准Suzetrigine用于中度至重度急性疼痛，标志着一类新型非阿片类镇痛药问世：它特异性阻断外周伤害性神经元上的NaV1.8通道，抑制动作电位产生，从源头阻断疼痛信号传入，理论上不引起镇静、呼吸抑制与成瘾。腹壁整形术与拇囊炎切除术的两项Ⅲ期试验中，其镇痛显著优于安慰剂；与氨酚氢可酮/对乙酰氨基酚相比，腹壁整形术后相当、拇囊炎切除术后略逊。紧随其后的LTG-001更进一步：2b期研究（343例腹壁整形术，NEJM 2026）中，高剂量组SPID48优于氨酚氢可酮/对乙酰氨基酚，中位起效约52分钟，52.3%的患者无需阿片补救。临床前研究还提示，阻断外周NaV1.8或可干预急性痛向慢性痛的转化，但尚待临床验证。国内同类药物亦在推进：HRS-2129已进入Ⅱ/Ⅲ期，HW231019处于Ⅱ期。 高选择性外周κ阿片受体激动剂——安瑞克芬：靶点选择性方面，氮杂螺环侧链结构提高安瑞克芬对κ受体的选择性，避免激动μ受体所致的呼吸抑制、成瘾与便秘等不良反应；外周选择性方面，四肽母核结构使安瑞克芬不易透过血脑屏障，也避免激动中枢κ受体所致的镇静、烦躁焦虑与多尿等不良反应。2025年5月国内获批用于腹部手术后轻、中度疼痛，为首个获批镇痛适应症的外周κ受体激动剂。Ⅲ期研究（387例）中疗效非劣于曲马多、优于安慰剂，恶心呕吐（7.8%、8.5%）远低于曲马多（41.1%、37.2%），不良事件与安慰剂相当，未见中枢反应。 四、人工智能（AI）赋能与未来展望 1.AI在麻醉与围术期领域的应用 AI在麻醉领域的应用正不断拓展，涵盖围术期全流程的AI临床决策支持、术中生理参数的AI监测与预测、麻醉教学、麻醉药物智能控制管理、困难气道预测、术后疼痛管理中的AI辅助、AI优化加速康复外科（enhanced recovery after surgery，ERAS）路径、术后预后评估与并发症预测以及认知功能恢复中的AI辅助等多个维度。 2.AI赋能的远程智能监测 智能手机远程监测是实现围手术期精细化管理的重要手段。其高可行性与良好的依从性，不仅突破了传统线下随访的时空限制，更能实时捕捉患者术后动态变化，为医生及时调整诊疗方案、预防并发症提供关键数据支持。围手术期参与度方面，术前平均依从率为66%（中位数79%），术后平均依从率为60%（中位数71%）。频繁的生态瞬时评估（ecological momentary assessment，EMA）监测并未导致患者症状恶化或产生焦虑，反而通过持续的健康关注带来轻微的积极心理暗示，证明了该监测方式的安全性与心理相容性。 3.AI辅助的疼痛全流程管理 AI未来将覆盖疼痛管理的全流程。患者就诊前可将既往病史上传至电子病历中，线上回答关于疼痛和症状的问卷。AI实时读取相关数据进行鉴别诊断，并推荐患者补充信息和准备工作，以得到准确的诊断。医生收到相关信息后，可基于AI建议进行诊疗决策，提高决策准确性。在临床接诊阶段，医生收集推荐信息，开具诊断检查或治疗；AI实时调整鉴别诊断和可能性评分，推荐具体诊断检查。在额外检查阶段，结果自动录入电子病历，平台完成诊断性检查，传感器提供客观数据，医生自动收到警报；AI调整鉴别诊断，推荐基于更新结果的循证治疗。在诊断和治疗阶段，患者平台提供治疗反应和副作用的反馈，平台加速沟通和随访；AI回答患者问题，推荐治疗方案的修改，并在建议发生变化时自动提醒医生。  小结 急性疼痛管理已进入一个多维度协同演进的新时代，核心目标是以患者功能康复为中心的全程管理，最终实现减轻患者痛苦、改善长期预后、提升医疗安全。未来的诊疗模式将深度融合精准多模式镇痛理念与人工智能，在坚持循证医学及规范的基础上，不断拓展非阿片类药物与非药物疗法的应用边界。 麻醉医师作为急性疼痛管理的核心主导者，应积极拥抱这些变革，将最新证据与技术转化为个体化的临床实践，引领学科迈向更高水平。 声明：本微信公众号所刊载内容不代表本平台观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供参考。 编辑：吕明霞 审核：于丽水

The partnership will bring Qutenza ®, Vimovo ®, Palexia®and Zomig® to people living with pain in Asia-Pacific, spanning Hong Kong, Indonesia, Malaysia, Philippines, Singapore, Taiwan, Thailand and Vietnam. *Pain is a significant healthcare challenge in the region, due to the ageing population and the high burden of chronic diseases.[1],[2], [3] The partnership is a key step in Grünenthal's strategy to enhance patient care and expand access to its innovative medicines. AACHEN, Germany, Sept. 28, 2026 /PRNewswire/ -- Grünenthal, a global leader in pain management and research, and DKSH Business Unit Healthcare, a strategic healthcare business partner and leading provider of Market Expansion Services for pharmaceutical, over-the-counter (OTC), consumer health and medical device companies, today announced a new partnership agreement to bring four Grünenthal medicines, Qutenza®, Vimovo®, Palexia® and Zomig®, to Asia-Pacific, accelerating access to innovative pain therapies in the region. The partnership will support the availability of Grünenthal's pain medicines across eight markets in Asia-Pacific: Hong Kong, Indonesia, Malaysia, Philippines, Singapore, Taiwan, Thailand and Vietnam, bringing up to four new medicines to patients in each market, pending local regulatory approvals. Under the agreement, DKSH will commercialise the medicines on Grünenthal's behalf across the eight markets, being responsible for seeking local marketing authorisations and the activities of marketing, medical, market access, sales and distribution. Grünenthal will manufacture the medicines through its integrated global manufacturing network. "Qutenza®, Vimovo®, Palexia® and Zomig® have delivered meaningful benefits to millions of people living with pain worldwide. Through our partnership with DKSH, we are taking another significant step toward broadening access to proven therapies and extending the reach of our medicines to more patients who need them," said Jan Adams, Chief Commercial Officer, Grünenthal. "With pain affecting potentially hundreds of millions across Asia-Pacific, new care options that meet the broad spectrum of patient needs are critical. We are proud to join forces with DKSH to help improve lives and advance our vision of a World Free of Pain." "This partnership marks another important milestone in DKSH Healthcare's new chapter of growth. Grünenthal is a globally recognised leader in pain management, and we are proud to further strengthen our relationship through an expanded alliance partnership spanning eight markets across Asia-Pacific. Leveraging our Regional Partnership model and integrated end-to-end commercialisation platform, we are well positioned to accelerate growth, improve access to innovative therapies for patients across the region, and advance our mission of delivering Healthcare for All," said Patrik Grande, Global Head of Business Unit Healthcare, DKSH. Pain is a significant healthcare challenge in Asia-Pacific, due to the ageing population and the high burden of chronic diseases.1,2,3 Hundreds of millions of people in the region may be living with chronic pain, based on population figures and global estimates of chronic pain prevalence.2,3 Grünenthal and DKSH first established their partnership in 2023, when DKSH took over the commercialisation of the already established medicines Nebido®, Zomig® and Tramal® in selected Asia-Pacific markets. Under the new agreement, DKSH will now seek local marketing authorisations for Qutenza®, Vimovo®, Palexia® and Zomig® across the eight participating markets, with Zomig® being introduced in additional markets not covered by the 2023 agreement. About Qutenza® In Europe, Qutenza® is indicated for the treatment of peripheral neuropathic pain in adults, either alone or in combination with other medicinal products for the treatment of pain. Qutenza® (capsaicin) 8% topical system is approved in the US for the treatment of neuropathic pain associated with postherpetic neuralgia and for the treatment of neuropathic pain associated with diabetic peripheral neuropathy (DPN) of the feet in adults. Important US safety information is available at . About Vimovo ® Vimovo® (fixed-dose combination of esomeprazole and naproxen) is indicated in adults for the symptomatic treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis, in patients who are at risk for developing non-steroidal anti-inflammatory drug (NSAID)-associated gastric and/or duodenal ulcers and where treatment with lower doses of naproxen or of other NSAIDs is not considered sufficient. About Zomig ® Zomig® (zolmitriptan) is indicated as an oral formulation in adults aged 18 years and older for acute treatment of migraine headache with or without aura, and as a nasal spray in adults and adolescents aged 12 years and older for the acute treatment of migraine headache with or without aura and in adults for the acute treatment of cluster headache. About Palexia ® Palexia® (tapentadol) is indicated as a prolonged-release tablet for the management of severe chronic pain in adults which can be adequately managed only with opioid analgesics, and for the management of severe chronic pain in children above 6 years and adolescents, which can be adequately managed only with opioid analgesics. It is also indicated as a film-coated IR tablet for the relief of moderate to severe acute pain in adults which can be adequately managed only with opioid analgesic, and as an oral solution for the relief of moderate to severe acute pain in children* and adolescents from 2 years of age and in adults which can be adequately managed only with opioid analgesics. *in children restricted to hospital use where appropriate equipment to enable respiratory support is available. As with all symptomatic treatments, the continued use of tapentadol exceeding 3 days must be evaluated on an ongoing basis. Statement on the responsible use of opioids General considerations for the management of pain with any medication that contains an opioid mechanism of action. All opioid medications are not authorised for all types of pain indication. Always refer to the product prescribing information. An individualised, patient-centred approach for the diagnosis and treatment of pain is essential to establish a therapeutic alliance between patient and clinician. To optimise opioid treatment: It is important to optimally use multimodal, non-opioid approaches in acute and chronic pain before escalating to opioids or in conjunction with opioid therapy. Opioids should be used only when benefits for pain and function are expected to outweigh risks. Consider patient variables that may affect opioid dose for each patient prior to opioid use. During ongoing opioid therapy, clinicians should collaborate with patients to evaluate and carefully weigh benefits and risks of continuing opioid therapy and exercise care when increasing, continuing, or reducing opioid dosage. Make a careful selection of patients, abuse risk factors evaluated, and regular monitoring and follow-up implemented to ensure that opioids are used appropriately and in alignment with treatment goals (pain intensity and functionality) as agreed with the patient. Make patients aware of the potential side effects of opioids and the potential for developing tolerance, dependence and addiction. Addiction is possible even when opioids are taken as directed. Signs of opioid use disorder should be monitored and addressed. If an opioid is authorised and selected for treatment of acute pain, please consider: The use should be for the shortest necessary time. If an opioid is authorised and selected for treatment of chronic pain, please consider: To continue opioid therapy only if there is clinically meaningful improvement in pain and function that outweighs risks to patient safety. Regular monitoring, clinical reviews, re-evaluations are required for long-term opioid treatment to assess pain control, impact on lifestyle, physical and psychological well-being, side effects and continued need for treatment. How opioid therapy will be discontinued if benefits do not outweigh risks (CDC new ref), incl. tapering down the dose where possible. Patients and the general public can benefit from clear educational materials and awareness interventions to support the responsible use of opioids. About DKSH For more than 160 years, DKSH has been delivering growth for companies in Asia Pacific, Europe, and North America across its Business Units Healthcare, Consumer Goods, Performance Materials, and Technology. As a leading Market Expansion Services provider, DKSH offers sourcing, market insights, marketing and sales, e-commerce, distribution and logistics as well as after-sales services, following its purpose of enriching people's lives. DKSH is a participant of the United Nations Global Compact and adheres to its principles-based approach to responsible business. Listed on the SIX Swiss Exchange, DKSH operates in 35 markets with 26,840 specialists, generating net sales of CHF 11.1 billion in 2025. DKSH Business Unit Healthcare distributes pharmaceuticals, consumer health, over-the-counter products and medical devices. With around 7,580 specialists, the Business Unit generated net sales of CHF 5.8 billion in 2025. About Grünenthal Grünenthal is a global leader in pain management and related diseases. As a science-based, fully integrated pharmaceutical company, we have a long track record of bringing innovative treatments and state-of-the-art technologies to patients worldwide. Our purpose is to change lives for the better – and innovation is our passion. We focus all our activities and efforts on working towards our vision of a World Free of Pain. Grünenthal is headquartered in Aachen, Germany, and has affiliates in 28 countries across Europe, Latin America, and the U.S. Our products are available in approx. 100 countries. In 2025, Grünenthal employed around 4,100 people and achieved revenues of €1.8 billion. More information: Follow us on LinkedIn & Instagram For further information, please contact: Matt Crabb, Head of Global Communications (Interim) at Grünenthal [email protected] References [1] Vallath N, et al. Access to pain relief and essential opioids in the WHO South-East Asia Region: challenges in implementing drug reforms. WHO South-East Asia Journal of Public Health. 2018; 7(2). Available at: . Accessed September 2026. [2] The Lancet Regional Health – Western Pacific. Chronic pain in Asia: we don't have to endure. Lancet Reg Health West Pac. 2023; 33:100782. Available at: . Accessed September 2026. [3] World Health Organization. WHO South-East Asia Regional Strategy on Healthy Ageing 2024–2030. Available at: . Accessed September 2026. SOURCE Grünenthal Group 21% more press release views with Request a Demo