Department of Surgery, Institute for Plastic Surgery, Southern Illinois University School of Medicine, 747 North Rutledge Street, Springfield, IL 62794-9653, USA.
Department of Surgery, Division of Orthopaedic Surgery, Southern Illinois University School of Medicine, 701 North 1st Street, Suite D-306, Springfield, IL 62794-9638, USA.
Clin Plast Surg. 2020 Apr;47(2):323-334. doi: 10.1016/j.cps.2019.12.004. Epub 2020 Feb 5.
Perioperative pain management in surgery of the hand and upper extremity relies on a multimodal approach involving systemic, local, and presurgical considerations. A pain management plan should be tailored to each patient. Management of pain of patients undergoing upper extremity surgery begins before surgical intervention and continues postoperatively. Patient education, setting expectations, psychological interventions, and addressing risk factors associated with postoperative pain are critical to successful pain management. Intraoperative anesthesia is accomplished via a variety of means. Cryotherapy, transcutaneous electrical nerve stimulation, acupuncture, massage, and localized heat are used in concert with pharmacologic therapies postoperatively to continue pain management.
手和上肢手术的围手术期疼痛管理依赖于多模式方法，包括全身、局部和术前考虑。疼痛管理计划应根据每个患者的情况进行定制。接受上肢手术的患者的疼痛管理始于手术干预之前，并持续到术后。患者教育、设定预期、心理干预以及解决与术后疼痛相关的风险因素对于成功的疼痛管理至关重要。术中麻醉通过多种方式实现。术后还会联合使用冷冻疗法、经皮电神经刺激、针灸、按摩和局部热疗以及药物治疗来继续进行疼痛管理。
