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患者自控镇痛在骨科关节置换术中的有效性:一项系统综述。

The Effectiveness of Patient-Controlled Analgesia in Orthopedic Joint Replacements: A Systematic Review.

作者信息

Altamimi Reem, Bin Salamah Rawan, AlZelfawi Lama A, AlHarthi Alanood, AlMazroa Ghayda, Alkhalifa Mohammad, AlMutiri Wijdan A, AlMajed Ebtesam, AlAwadh Afnan, AlSarhan Reem, AlShebel Malak N, Hadaddi Rafa

机构信息

Collage of Medicine, Princess Nourah bint Abdulrahaman University, Riyadh 14256, Saudi Arabia.

College of Medicine, Qassim University, Qassim 52571, Saudi Arabia.

出版信息

Life (Basel). 2025 Feb 11;15(2):275. doi: 10.3390/life15020275.


DOI:10.3390/life15020275
PMID:40003684
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11857533/
Abstract

Orthopedic joint replacement procedures, including total hip and knee arthroplasty, are crucial interventions for managing degenerative joint diseases and enhancing patients' quality of life. Postoperative pain management remains a critical challenge affecting recovery and outcomes. Recognizing pain management as pivotal in patient care, this systematic review evaluates the effectiveness of patient-controlled analgesia (PCA) in orthopedic surgeries. This systematic review synthesizes the current literature to assess PCA's role in orthopedic joint replacements. Studies focusing on pain relief, opioid consumption, hospital stays, rehabilitation outcomes, and patient satisfaction were analyzed. Significant findings were extracted from statistical analyses to evaluate PCA's efficacy compared to traditional pain management methods. PCA significantly improves postoperative pain relief ( < 0.05), leading to a 30% reduction in opioid consumption and a 20% shorter hospital stay on average compared to traditional methods. Additionally, patients using PCA reported higher satisfaction scores (85% vs. 65%) and demonstrated improved rehabilitation outcomes, enhancing overall recovery and quality of life post surgery. This review underscores PCA's effectiveness as a superior strategy for postoperative pain management in orthopedic joint replacements. By reducing pain, opioid use, and hospitalization duration and enhancing rehabilitation outcomes, PCA contributes significantly to improving patient outcomes and healthcare efficiency.

摘要

骨科关节置换手术,包括全髋关节和膝关节置换术,是治疗退行性关节疾病和提高患者生活质量的关键干预措施。术后疼痛管理仍然是影响康复和治疗结果的关键挑战。鉴于疼痛管理在患者护理中的关键作用,本系统评价评估了患者自控镇痛(PCA)在骨科手术中的有效性。本系统评价综合当前文献,以评估PCA在骨科关节置换中的作用。分析了关注疼痛缓解、阿片类药物使用、住院时间、康复结果和患者满意度的研究。从统计分析中提取重要发现,以评估PCA与传统疼痛管理方法相比的疗效。与传统方法相比,PCA显著改善了术后疼痛缓解(P<0.05),平均阿片类药物使用量减少了30%,住院时间缩短了20%。此外,使用PCA的患者报告的满意度得分更高(85%对65%),康复结果也有所改善,提高了术后的整体恢复情况和生活质量。本评价强调了PCA作为骨科关节置换术后疼痛管理的一种更优策略的有效性。通过减轻疼痛、减少阿片类药物使用和缩短住院时间以及改善康复结果,PCA对改善患者治疗结果和医疗效率做出了重大贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c68b/11857533/cb6c79f3d2f0/life-15-00275-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c68b/11857533/cb6c79f3d2f0/life-15-00275-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c68b/11857533/cb6c79f3d2f0/life-15-00275-g001.jpg

相似文献

[1]
The Effectiveness of Patient-Controlled Analgesia in Orthopedic Joint Replacements: A Systematic Review.

Life (Basel). 2025-2-11

[2]
The effectiveness of orthopedic patient education in improving patient outcomes: a systematic review protocol.

JBI Database System Rev Implement Rep. 2015-1

[3]
Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis.

Ont Health Technol Assess Ser. 2005

[4]
Epidural analgesia for pain relief following hip or knee replacement.

Cochrane Database Syst Rev. 2003

[5]
A pre-emptive multimodal pathway featuring peripheral nerve block improves perioperative outcomes after major orthopedic surgery.

Reg Anesth Pain Med. 2008

[6]
Femoral nerve blocks for acute postoperative pain after knee replacement surgery.

Cochrane Database Syst Rev. 2014-5-13

[7]
Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain.

Cochrane Database Syst Rev. 2015-6-2

[8]
Role of Parecoxib Sodium in the Multimodal Analgesia after Total Knee Arthroplasty: A Randomized Double-blinded Controlled Trial.

Orthop Surg. 2018-11

[9]
Effects of perioperative administration of a selective cyclooxygenase 2 inhibitor on pain management and recovery of function after knee replacement: a randomized controlled trial.

JAMA. 2003-11-12

[10]
Examining postoperative care: Predictors of perceived pain relief and satisfaction with pain management after orthopedic surgeries.

Int J Orthop Trauma Nurs. 2025-2

本文引用的文献

[1]
Comparison of Intravenous Acetaminophen and Intravenous Patient-Controlled Analgesia Fentanyl after Total Hip Arthroplasty: A Multicenter Randomized Controlled Trial.

J Clin Med. 2023-11-30

[2]
Predictors of severe postoperative pain after orthopedic surgery in the immediate postoperative period.

Int J Orthop Trauma Nurs. 2021-11

[3]
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.

BMJ. 2021-3-29

[4]
A Prospective Randomized Trial of an Oral Patient-Controlled Analgesia Device Versus Usual Care Following Total Hip Arthroplasty.

Orthop Nurs. 2020

[5]
RoB 2: a revised tool for assessing risk of bias in randomised trials.

BMJ. 2019-8-28

[6]
Periarticular injection and continuous femoral nerve block versus continuous femoral nerve block alone on postoperative opioid consumption and pain control following total knee arthroplasty: Randomized controlled trial.

J Clin Orthop Trauma. 2019

[7]
Patient-controlled epidural analgesia versus conventional epidural analgesia after total hip replacement - a randomized trial.

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020-3

[8]
Oral prolonged-release oxycodone/naloxone offers equivalent analgesia to intravenous morphine patient-controlled analgesia after total knee replacement. A randomized controlled trial.

Minerva Anestesiol. 2018-1-16

[9]
Peri-articular injections of local anaesthesia can replace patient-controlled analgesia after total knee arthroplasty: a randomised controlled study.

Int Orthop. 2016-2

[10]
Patient-controlled epidural analgesia or multimodal pain regimen with periarticular injection after total hip arthroplasty: a randomized, double-blind, placebo-controlled study.

J Bone Joint Surg Am. 2015-5-20

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