Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
J Arthroplasty. 2010 Apr;25(3):410-5. doi: 10.1016/j.arth.2010.01.003. Epub 2010 Feb 9.
Pain management after total hip arthroplasty has improved dramatically in the past decade. However, most protocols use opioid medications for pain control. In the current study, 100 patients were prospectively selected to receive a traditional narcotic-based patient-controlled analgesia protocol or a nonnarcotic oral protocol for pain management after primary total hip arthroplasty. Therapy programs were similar for both groups. Postoperatively, patients were followed daily for opioid use, medication adverse effects, pain control, and overall satisfaction. The nonnarcotic oral group showed lower mean pain scores during the first 24 hours after surgery. The satisfaction rate was high in both groups. Both protocols provided adequate pain control after total hip arthroplasty; the nonnarcotic pain management protocol resulted in significantly decreased opioid consumption and fewer adverse effects.
在过去的十年中，全髋关节置换术后的疼痛管理有了显著的改善。然而，大多数方案都使用阿片类药物来控制疼痛。在本研究中，前瞻性地选择了 100 名患者，分别接受传统的基于阿片类药物的患者自控镇痛方案或非阿片类口服方案进行初次全髋关节置换术后的疼痛管理。两组的治疗方案相似。术后，每天对患者进行随访，以了解阿片类药物的使用情况、药物不良反应、疼痛控制和总体满意度。在手术后的 24 小时内，非阿片类口服组的平均疼痛评分较低。两组的满意度均较高。两种方案均能充分控制全髋关节置换术后的疼痛；非阿片类疼痛管理方案可显著减少阿片类药物的使用和不良反应的发生。
