Department of Anesthesiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, Genk 3600, Belgium.
Department of Anesthesiology, Ziekenhuis Oost-Limburg (ZOL), Schiepse Bos 6, Genk 3600, Belgium.
Anesthesiol Clin. 2022 Sep;40(3):537-545. doi: 10.1016/j.anclin.2022.04.003. Epub 2022 Jul 12.
Joint replacements are increasingly performed as outpatient surgeries. The push toward ambulatory joint arthroplasty is driven in part by the changing current health care economics and reimbursement models. Patients' selection and well-designed perioperative care pathways are critical for the success of these procedures. The rate of complications after outpatient joint arthroplasty is comparable to the rate of complications in the ambulatory setting. Patient education, adequate social support, multimodal analgesia, regional anesthesia are key ingredients to the ambulatory care pathway after joint arthroplasty. Motor sparing nerve blocks are often used in these settings. Implementation of the elements of fast protocols can result in overall improvement of outcome metrics for all patients undergoing joint arthroplasty, including reduced length of stay and increased rate of home discharge.
关节置换术越来越多地作为门诊手术进行。推动关节置换术向门诊发展的部分原因是当前医疗保健经济和报销模式的变化。患者的选择和精心设计的围手术期护理路径对于这些手术的成功至关重要。门诊关节置换术后的并发症发生率与门诊环境中的并发症发生率相当。患者教育、充分的社会支持、多模式镇痛、区域麻醉是关节置换术后门诊护理路径的关键组成部分。运动神经阻滞在这些情况下经常使用。快速方案要素的实施可以使所有接受关节置换术的患者的总体结果指标得到改善，包括住院时间缩短和出院回家率提高。
