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髋膝关节置换术中的围手术期疼痛管理

Perioperative Pain Management in Hip and Knee Arthroplasty.

作者信息

Gaffney Christian J, Pelt Christopher E, Gililland Jeremy M, Peters Christopher L

机构信息

Department of Orthopaedics, The University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

Department of Orthopaedics, The University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

出版信息

Orthop Clin North Am. 2017 Oct;48(4):407-419. doi: 10.1016/j.ocl.2017.05.001. Epub 2017 Jun 29.

Abstract

Total hip and knee arthroplasty is associated with significant perioperative pain, which can adversely affect recovery by increasing risk of complications, length of stay, and cost. Historically, opioids were the mainstay of perioperative pain control. However, opioids are associated with significant downsides. Preemptive use of a multimodal pain management approach has become the standard of care to manage pain after hip and knee arthroplasty. Multimodal pain management uses oral medicines, peripheral nerve blocks, intra-articular injections, and other tools to reduce the need for opioids. Use of a multimodal approach promises to decrease complications, improve outcomes, and increase patient satisfaction after hip and knee arthroplasty.

摘要

全髋关节和膝关节置换术会导致严重的围手术期疼痛,这可能会因增加并发症风险、住院时间和成本而对恢复产生不利影响。从历史上看,阿片类药物是围手术期疼痛控制的主要手段。然而,阿片类药物存在显著的缺点。在髋关节和膝关节置换术后,预先采用多模式疼痛管理方法已成为管理疼痛的护理标准。多模式疼痛管理使用口服药物、外周神经阻滞、关节内注射和其他工具来减少对阿片类药物的需求。采用多模式方法有望减少髋关节和膝关节置换术后的并发症、改善治疗效果并提高患者满意度。

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