Goode Victoria M, Morgan Brett, Muckler Virginia C, Cary Michael P, Zdeb Christine E, Zychowicz Michael
Victoria M. Goode, PhD, CRNA, Duke University School of Nursing, Durham, NC. Brett Morgan, DNP, CRNA, Duke University School of Nursing, Durham, NC. Virginia C. Muckler, DNP, CRNA, CHSE, Duke University School of Nursing, Durham, NC. Michael P. Cary, Jr., PhD, RN, Duke University School of Nursing, Durham, NC. Christine E. Zdeb, BSN, RN, ONC, Duke University School of Nursing, Durham, NC. Michael Zychowicz, DNP, ANP, ONP, FAAN, FAANP, Duke University School of Nursing, Durham, NC.
Orthop Nurs. 2019 Mar/Apr;38(2):150-156. doi: 10.1097/NOR.0000000000000525.
Effective pain management for orthopaedic major joint replacement is key to achieving earlier recovery, better functioning, and high rates of patient satisfaction. In an effort to decrease opioid dependency, practitioners are turning to multimodal pain management, which involves the use of multiple analgesic agents and techniques. To utilize this technique, a patient's history of and preoperative consumption of medications to treat pain impacts the success of this regimen. Multimodal pain management involves the use of nonsteroidal anti-inflammatory drugs, acetaminophen, N-methyl-D-aspartate antagonists, gabapentin, serotonin inhibitors, regional techniques, and opioids as needed. It is necessary for the nurse to understand the mechanism of pain and how the multimodal adjuncts target the pain response to benefit the patient's perioperative course as well as his or her postoperative and discharge management.
有效的骨科大关节置换疼痛管理是实现早期康复、更好功能恢复和高患者满意度的关键。为了减少阿片类药物依赖，从业者正在转向多模式疼痛管理，这涉及使用多种镇痛药物和技术。为了运用这项技术，患者治疗疼痛的用药史和术前用药情况会影响该治疗方案的成功率。多模式疼痛管理包括根据需要使用非甾体抗炎药、对乙酰氨基酚、N-甲基-D-天冬氨酸拮抗剂、加巴喷丁、血清素抑制剂、区域技术和阿片类药物。护士有必要了解疼痛机制以及多模式辅助药物如何针对疼痛反应，以利于患者的围手术期过程以及术后和出院管理。
