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肩关节置换术后的疼痛控制

Postoperative pain control for shoulder arthroplasty.

作者信息

Walker Mahala, Kamineni Srinath

机构信息

University of Kentucky College of Medicine, Lexington, KY, USA.

Department of Orthopedic Surgery, Elbow Shoulder Research Center, University of Kentucky College of Medicine, Lexington, KY, USA.

出版信息

Clin Shoulder Elb. 2024 Dec;27(4):496-504. doi: 10.5397/cise.2023.00850. Epub 2024 Feb 14.

Abstract

Since its inception in 1893, shoulder arthroplasty has become an increasingly common surgical procedure. Between 1998 and 2008, shoulder arthroplasty procedures increased by nearly 28,000 cases per year in the United States alone and is the fastest growing joint replacement surgery among all joint. Despite its advantages, shoulder arthroplasty is often accompanied by significant postoperative pain. Pain control continues to be a major concern in patient management, as it impacts operative costs, postoperative mobility, length of hospital stay, patient satisfaction, and overall surgical outcomes. This review aims to provide an overview of drugs such as opioids and regional anesthetics, as well as methods such as local wound infiltration, nerve block, brachial plexus infiltration, cryotherapy and multimodal approaches employed in postoperative shoulder arthroplasty pain control.

摘要

自1893年首次开展以来,肩关节置换术已成为一种越来越常见的外科手术。仅在美国,1998年至2008年间,肩关节置换手术每年就增加近28000例,是所有关节置换手术中增长最快的。尽管肩关节置换术有其优点,但术后常伴有明显疼痛。疼痛控制仍然是患者管理中的一个主要问题,因为它会影响手术成本、术后活动能力、住院时间、患者满意度和整体手术效果。本综述旨在概述阿片类药物和局部麻醉药等药物,以及局部伤口浸润、神经阻滞、臂丛神经浸润、冷冻疗法和多模式方法等用于术后肩关节置换术疼痛控制的方法。

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