Barrington John W
Baylor Medical Center, Frisco Joint Replacement Center, Plano, TX.
Am J Orthop (Belle Mead NJ). 2016 Nov/Dec;45(7):S2-S5.
Postoperative pain management is vital to promoting recovery and improving clinical outcomes. Although improved understanding of pain pathways has led to the development of varied approaches for controlling pain after surgery, some approaches are associated with potentially harmful side effects. Several lines of evidence have demonstrated that opioid analgesics can have unwanted adverse effects on patients having surgery. Similarly, risks associated with femoral nerve blocks have outweighed the benefits. Liposomal bupivacaine has shown efficacy in reducing the need for opioid analgesics and nerve blocks. Specifically, use of liposomal bupivacaine in a multimodal analgesia plan resulted in superior clinical and economic parameters in total joint arthroplasty. These advantages of liposomal bupivacaine are valuable in the current health care environment and in outpatient joint arthroplasty, in which highly effective opioid-sparing pain management is a prerequisite. Thus, liposomal bupivacaine can be used to reduce the burden of opioids and facilitate same-day discharge, thereby addressing some of the challenges associated with implementing short-stay or outpatient total joint arthroplasty.
术后疼痛管理对于促进恢复和改善临床结果至关重要。尽管对疼痛通路的深入了解促使人们开发出多种术后疼痛控制方法，但有些方法可能会带来潜在的有害副作用。多项证据表明，阿片类镇痛药可能会给手术患者带来不良影响。同样，股神经阻滞的风险已超过其益处。脂质体布比卡因已显示出在减少阿片类镇痛药和神经阻滞需求方面的疗效。具体而言，在多模式镇痛方案中使用脂质体布比卡因，在全关节置换术中产生了更优的临床和经济参数。脂质体布比卡因的这些优势在当前的医疗环境以及门诊关节置换术中具有重要价值，在门诊关节置换术中，高效的阿片类药物节省型疼痛管理是一项前提条件。因此，脂质体布比卡因可用于减轻阿片类药物的负担并促进当日出院，从而应对与实施短期住院或门诊全关节置换术相关的一些挑战。
