髋关节置换围手术期的多模式疼痛管理  

Multi-modal Pain Management in the Perioperative Period of Hip Replacement

作　　者：姚孟轩 霍佳[1] 魏聪聪 李会杰[1] Yao Mengxuan;Huo Jia;Wei Congcong;Li Huijie(Department of Orthopaedics,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院骨病科,石家庄050051

出　　处：《中华老年骨科与康复电子杂志》2020年第6期370-375,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：河北省自然科学基金(H2019206609)。

摘　　要：全髋关节置换术(THA)是一种常见的骨科手术,在围手术期无效的疼痛控制可能会导致恢复变慢、并发症风险增加、医疗费用增加和患者满意度的下降。对于THA围手术期的疼痛控制也越来越受到广大骨科医师的重视。多模式疼痛管理方法逐渐成为主流,其包括:口服药物(例如COX-2抑制剂、神经调节剂)、外周神经阻滞、局部麻醉镇痛和其他方式。通过不同药物和/或方法间的协同作用,来增强镇痛的效果,降低单一药物的使用剂量及不良反应,缩短药物起效时间以及延长镇痛持续时间。Total hip arthroplasty(THA)is a common orthopedic procedure,and ineffective pain control during the perioperative period may lead to slower recovery,increased risk of complications,increased medical costs,and decreased patient satisfaction.More and more attention has been paid to pain control during the perioperative period of THA by the majority of orthopedic surgeons.A multimodal approach to pain management has gradually become mainstream,which includes:oral agents(e.g.,COX-2 inhibitors,neuromodulators),peripheral nerve blocks,local anesthetic analgesia,and other modalities.The use of a multimodal approach promises to reduce complications,improve pain and improve patient satisfaction after hip arthroplasty.Enhance the analgesic effect through the synergistic effect between different drugs and/or methods,reduce the dosage and adverse reactions of single drug,shorten the onset time of drugs and prolong the duration of analgesia.

关 键 词：关节成形术 置换 髋 疼痛管理 多模式镇痛 

分 类 号：R687.4[医药卫生—骨科学]