Fikentscher T, Grifka J, Benditz A
Orthopädische Klinik für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl V. Allee 3, 93077, Bad Abbach, Deutschland.
Orthopade. 2015 Sep;44(9):727-740. doi: 10.1007/s00132-015-3152-6.
A sufficient pain management forms the foundation for a successful operative treatment of orthopedic patients. Clinical guideline standards must be provided to ensure safe and immediate pain therapy. Training in these guidelines should be held for clinical personnel on a regular basis. The visual analog scale (VAS) and the numerical rating scale (NRS) are valid instruments used for assessment of pain intensity. A sufficient pain management includes basic analgesics, analgesics on demand as well as special features, such as regional nerve blocks and patient-controlled anesthesia (PCA). The basic analgesics are primarily the groups of classical non-steroidal anti-inflammatory drugs (NSAID) and cyclooxygenase 2 (COX-2) inhibitors as well as stand by analgesics, such as metamizole. If there is further need for pain therapy, medium strong and strong opioids can be used but adverse events must be taken into consideration.
充分的疼痛管理是骨科患者手术治疗成功的基础。必须提供临床指南标准以确保安全、即时的疼痛治疗。应定期为临床人员开展这些指南的培训。视觉模拟评分法（VAS）和数字评定量表（NRS）是用于评估疼痛强度的有效工具。充分的疼痛管理包括基础镇痛药、按需使用的镇痛药以及特殊方法，如区域神经阻滞和患者自控镇痛（PCA）。基础镇痛药主要是经典的非甾体抗炎药（NSAID）组和环氧化酶2（COX-2）抑制剂以及备用镇痛药，如安乃近。如果进一步需要疼痛治疗，可以使用中强效和强效阿片类药物，但必须考虑不良事件。
