Horlocker Terese T
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Orthopedics. 2010 Sep;33(9 Suppl):14-9. doi: 10.3928/01477447-20100722-65.
Patients undergoing total hip and knee arthroplasty experience substantial and sustained postoperative pain. Inadequate analgesia may impede recovery and delay hospital discharge. Traditionally, postoperative analgesia following arthroplasty was provided by intravenous patient-controlled analgesia or epidural analgesia, but each technique has distinct advantages and disadvantages. Recently, peripheral nerve blockade of the lumbosacral plexus has emerged as an alternative analgesic approach. An increasing number of studies have reported multimodal analgesia featuring unilateral peripheral block provide pain relief and functional outcomes similar to that of continuous epidural and superior to systemic analgesia but with fewer side effects. This review discusses the indications, benefits, and side effects associated with conventional and innovative analgesic approaches to facilitate rehabilitation and improve outcome following total joint arthroplasty.
接受全髋关节和膝关节置换术的患者术后会经历持续且强烈的疼痛。镇痛不足可能会阻碍恢复并延迟出院。传统上，关节置换术后的镇痛是通过静脉自控镇痛或硬膜外镇痛来实现的，但每种技术都有其独特的优缺点。最近，腰骶丛周围神经阻滞已成为一种替代镇痛方法。越来越多的研究报告称，以单侧周围阻滞为特色的多模式镇痛在缓解疼痛和功能恢复方面与持续硬膜外镇痛相似，且优于全身镇痛，但副作用更少。本文综述了与传统和创新镇痛方法相关的适应症、益处和副作用，以促进全关节置换术后的康复并改善预后。
