全膝关节置换手术围手术期镇痛方式研究现状  

Current research on perioperative analgesic methods for total knee arthroplasty

作　　者：沈登萍 Shen Dengping(Department of Joint Surgery,Pinghu Hospital of Traditional Chinese Medicine affiliated to Jiaxing University,Jiaxing City,Zhejiang Province 314200,China)

机构地区：[1]嘉兴大学附属平湖市中医院关节外科,浙江省嘉兴市314200

出　　处：《中华疼痛学杂志》2024年第5期786-791,共6页Chinese Journal Of Painology

摘　　要：目前临床上正在从单一的镇痛模式向多模式镇痛转变,围手术期全过程疼痛管理和多模式镇痛已成为全膝关节置换术(TKA)围手术期镇痛的主要方案,对改善TKA效果、提升患者术后满意度具有重要价值。临床阿片类镇痛药物应用仍具有重要地位,使用阿片类药物会引起诸多不良反应,因此应避免不必要的阿片类药物使用。关节周围多模式药物混合液注射、硬膜外镇痛(EA)、神经阻滞以及中医类包括耳穴贴压、冷疗、艾灸、推拿等为代表的镇痛措施,在临床上应用效果显著、不良反应较小。在TKA术后多模式镇痛体系中的作用日益显现。Perioperative pain management and multi-mode analgesia have become the most important scheme for total knee arthroplasty(TKA)perioperative analgesia.It has important value in improving the postoperative effect of TKA and improving the postoperative satisfaction of patients.The opioids still play an important role in the perioperative analgesia,because many adverse reactions,unnecessary opioids should be avoided.Multi-modal analgesic measures,such as drug mixing injection around the joint,epidural analgesia(EA),nerve block and traditional Chinese medicine including acupoint pressure,cold therapy,moxibustion,massage,have significant clinical effects and few adverse reactions,and multi-mode analgesic system are used increasingly in the TKA patients.

关 键 词：全膝关节置换术 疼痛管理 多模式镇痛 围手术期 

分 类 号：R68[医药卫生—骨科学]