Mejía-Terrazas G E, Peña-Riveron A, Unzueta-Navarro D
Acta Ortop Mex. 2013 Jul-Aug;27(4):273-8.
Patients undergoing joint replacement surgery may experience intense and sustained postoperative pain due to inappropriate analgesia that delays recovery and hospital discharge. Traditionally, postoperative analgesia following arthroplasty is achieved with scheduled analgesia, either patient-controlled or with epidural spinal blocks. The former techniques have advantages and disadvantages. Recently, peripheral nerve block has emerged as an appropriate alternative for postoperative pain. Numerous trials report that the use of multimodal analgesia based on peripheral nerve blocks may control pain and offer functional results similar to those obtained with continuous epidural blocks or systemic opioids, but without their unwanted systemic effects. This review discusses the indications, benefits and adverse effects associated with standard and new analgesic techniques.
接受关节置换手术的患者可能会因镇痛不当而经历强烈且持续的术后疼痛,这会延迟康复和出院时间。传统上,关节置换术后的镇痛是通过定时镇痛来实现的,要么是患者自控镇痛,要么是硬膜外脊髓阻滞。前一种技术有其优缺点。最近,外周神经阻滞已成为术后疼痛的一种合适替代方法。大量试验报告称,基于外周神经阻滞的多模式镇痛可控制疼痛,并提供与持续硬膜外阻滞或全身性阿片类药物相似的功能结果,但不会产生不良的全身影响。本综述讨论了与标准和新镇痛技术相关的适应症、益处和不良反应。