骨科、麻醉科加速康复围手术期疼痛、睡眠和焦虑障碍管理专家共识  

Expert consensus on the management of perioperative pain,sleep,and anxiety disorders in orthopaedics and anesthesiology for enhanced recovery after surgery

作　　者：中国康复技术转化及发展促进会 中华医学会麻醉学分会 中国医师协会麻醉学医师分会 中国研究型医院学会 谢锦伟[2] 杨静[3] 黄强[2] 李军[4] 李桃美 刁玉刚 金群华[7] 孙天胜 周宗科[2] 李庭 钱齐荣 顾小萍[11] 何金汗[12] 肖涟波 郭向阳[14] 雷光华[15] 朱涛[3] 张长青[16] 缪长虹 杨惠林[18] 俞卫锋[19] 裴福兴[2] China Association of Rehabilitation Technology Transformation and Promotion;Chinese Medical Association of Anesthesiology;Chinese Medical Doctor Association of Anesthesiologist;Chinese Research Hospital Association;XIE Jinwei;YANG Jing;HUANG Qiang;LI Jun;LI Taomei;DIAO Yugang;JIN Qunhua;SUN Tiansheng;ZHOU Zongke;LI Ting;QIAN Qirong;GU Xiaoping;HE Jinhan;XIAO Lianbo;GUO Xiangyang;LEI Guanghua;ZHU Tao;ZHANG Changqing;MIAO Changhong;YANG Huiling;YU Weifeng;PEI Fuxing(不详;Department of Orthopaedic Surgery,West China Hospital,Sichuan University,Chengdu 610041,China;Department Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Anesthesiology,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China;Mental Health Center,West China Hospital,Sichuan University,C hengdu 610041,China;Department of Anesthesiology,General Hospital of Northern Theater Command,Shenyang 110000,China;Department of Orthopaedics,General Hospital of Ningxia Medical University,Yinchuan 750003,China;Senior Department of Orthopaedics,the Chinese People's Liberation Army General Hospital,Beijing 100007,China;Department of Orthopaedics,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Department of Orthopaedics,the Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;Department of Anesthesiology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Clinical Pharmacy,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Orthopaedics,Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 200052,China;Department of Anesthesiology,Peking University Third Hospital,Beijing 100083,China;Department of Orthopaedics,Xiangya Hospital of Central South University,Changsha 410008,China;Department of Orthopaedics,Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200030,China;Department of

机构地区：[1]不详 [2]四川大学华西医院骨科,成都610041 [3]四川大学华西医院麻醉科,成都610041 [4]温州医科大学附属第二医院麻醉科,浙江温州325027 [5]四川大学华西医院心理卫生中心,成都610041 [6]北部战区总医院麻醉科,沈阳110000 [7]宁夏医科大学总医院骨科,银川750003 [8]中国人民解放军总医院骨科医学部,北京100007 [9]首都医科大学附属北京积水潭医院骨科,北京100035 [10]海军军医大学第二附属医院骨科,上海200003 [11]南京大学医学院附属鼓楼医院麻醉科,南京210008 [12]四川大学华西医院临床药学部,成都610041 [13]上海光华中西医结合医院骨科,上海200052 [14]北京大学第三医院麻醉科,北京100083 [15]中南大学湘雅医院骨科,长沙410008 [16]上海交通大学医学院附属第六人民医院骨科,上海200030 [17]复旦大学附属中山医院麻醉科,上海200032 [18]苏州大学附属第一医院骨科,江苏苏州215006 [19]上海交通大学医学院附属仁济医院麻醉科,上海200127

出　　处：《中华骨与关节外科杂志》2025年第3期212-221,共10页Chinese Journal of Bone and Joint Surgery

摘　　要：疼痛、睡眠障碍与焦虑障碍是影响骨科患者满意度及加速康复实施的三大重要因素,三者相互影响、互为因果。将围手术期疼痛、睡眠障碍和焦虑障碍管理一体化已逐步得到骨科、麻醉科、精神科等多学科医师的广泛认可,但距离加速康复外科无痛、舒适的目标仍有一定差距。本共识基于德尔菲法的实践要求,对骨科和麻醉科医师共同关注的疼痛、睡眠和焦虑障碍的术前评估与宣教、术前疼痛的治疗与预防性镇痛等15个临床问题相关的循证医学证据与临床实践进行了系统总结,形成共识推荐,旨在促进以患者为中心的骨科加速康复的实施。Pain,sleep disorders,and anxiety disorders are three major factors that affect the satisfaction of orthopaedic patients and the implementation of enhanced recovery after surgery(ERAS).These factors interact with each other and are mutually causal.The integration of perioperative pain,sleep disorders,and anxiety disorders has gradually gained recognition from multidisciplinary physicians,including those in orthopaedics,anesthesiology,and psychiatry.However,there remains a gap in achieving the ERAS goal of being painless and comfortable.Based on the practical requirements of the Delphi method,this consensus systematically summarizes the evidence-based medicine and clinical practice related to 15 clinical issues,including preoperative assessment and education for pain,sleep disorders,and anxiety disorders,as well as preoperative pain treatment and preventive analgesia,which are of common concern to orthopaedists and anesthesiologists.It forms consensus recommendations with the aim of promoting the implementation of patient-centered ERAS in orthopaedics.

关 键 词：疼痛管理 睡眠障碍 焦虑障碍 加速康复外科 专家共识 

分 类 号：R68[医药卫生—骨科学] R614[医药卫生—外科学]