全关节置换术后的围手术期疼痛管理：机构疼痛方案的综述与更新
Perioperative pain management following total joint arthroplasty: A review and update to an institutional pain protocol.
作者信息
Stevenson Kimberly L, Neuwirth Alexander L, Sheth Neil
机构信息
Resident Department of Orthopaedic Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, United States.
Department of Orthopaedic Surgery, University of Pennsylvania, 800 Spruce Street - 8th Floor Preston Building, Philadelphia, PA 19107, United States.
出版信息
J Clin Orthop Trauma. 2018 Jan-Mar;9(1):40-45. doi: 10.1016/j.jcot.2017.09.014. Epub 2017 Sep 28.
Abstract
As the rate of total joint arthroplasty increases with the aging population of the United States, new focus on decreasing opioid use through the development of multimodal pain regimens (MPRs) is becoming an important area of research. MPRs use different agents and modes of delivery in order to synergistically address pain at many levels of the pain pathway. MPRs include a combination of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, opioids (short- and long-acting), spinal/epidural analgesia, regional nerve blocks, and local anesthetics. This review summarizes the available literature on major components of MPRs shown to be effective in the total joint arthroplasty population. Finally, the authors' preferred method for pain control in the TJA population is reviewed.
摘要
随着美国人口老龄化，全关节置换术的发生率不断上升，通过开发多模式镇痛方案（MPR）来减少阿片类药物使用的新焦点正成为一个重要的研究领域。MPR使用不同的药物和给药方式，以便在疼痛通路的多个层面协同解决疼痛问题。MPR包括对乙酰氨基酚、非甾体抗炎药（NSAID）、加巴喷丁类药物、阿片类药物（短效和长效）、脊髓/硬膜外镇痛、区域神经阻滞和局部麻醉剂的联合使用。本综述总结了关于MPR主要成分的现有文献，这些成分已被证明在全关节置换术人群中有效。最后，回顾了作者在全关节置换术人群中首选的疼痛控制方法。
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