国际麻醉学与复苏杂志   2018, Issue (7): 0-0
    
全膝关节置换围术期镇痛方法的临床研究进展
潘四磊, 王梅芳, 濮健峰1()
1.扬州大学
Clinical research progress of perioperative analgesia in total knee arthroplasty
 全文:
摘要:

背景 全膝关节置换术(total knee arthroplasty,TKA)围手术期疼痛的管理对于麻醉医师来说是一项非常棘手的问题。临床上的镇痛方法多样,每种镇痛方法都有其优势和不足。目的 回顾近些年来临床常用的TKA术后的镇痛方法,并对每种方法的优劣势及可行性进行综述。内容 本文主要介绍TKA术后常用的镇痛方法,其中包括静脉自控镇痛、硬膜外自控镇痛等传统方法,股神经阻滞、收肌管阻滞等外周神经阻滞,和近几年骨科医师所喜欢的膝关节周围阻滞浸润注射,以及冷疗等物理方法,还有超前镇痛、多模式镇痛等。趋向 探讨各种镇痛方法在TKA术后的安全性及可行性,为临床上TKA术后镇痛提供指导意见。

关键词: 围术期;全膝关节置换;镇痛;多模式镇痛
Abstract:

Background Total knee arthroplasty(TKA)perioperative pain management is still a very tricky problem for anesthesiologist. Clinically analgesia methods are varied,every analgesia method has it’s advantage and disadvantage. Objective This review will focus on advantage and disadvantage of every analgesia method after TKA which is commonly used in recent years. Content This paper introduces common analgesic methods for TKA, these include patient-controlled intravenous analgesia、patient-controlled epidural analgesia and other traditional method, femoral nerve block、adductor canal block and other peripheral nerve block,and periarticular infiltration that loved by orthopedist in recent years,cold therapy and other physical methods,preemptive analgesia、multimodal analgesia, etc. Trend To research the safety and feasibility of every analgesia method after TKA will contribute to provide guidance for TKA.

Key words: Perioperative period;Total knee arthroplasty;Analgesia;Multimodal analgesia