基础医学与临床 ›› 2017, Vol. 37 ›› Issue (4): 567-570.

• 短篇综述 • 上一篇    下一篇

膝关节置换术的围术期区域镇痛方式选择

车璐1,唐帅2,黄宇光1   

  1. 1. 北京协和医院
    2. 北京协和医院麻醉科
  • 收稿日期:2016-08-25 修回日期:2017-01-11 出版日期:2017-04-05 发布日期:2017-03-24
  • 通讯作者: 唐帅 E-mail:tangshuai234@sina.com

Perioperative regional pain management of TKA

  • Received:2016-08-25 Revised:2017-01-11 Online:2017-04-05 Published:2017-03-24

摘要: 高质量的围术期疼痛管理对于全膝关节置换术(TKA)后的快速康复和改善功能恢复都十分重要。随着区域麻醉技术的发展和超声在麻醉镇痛领域的应用,股神经阻滞、坐骨神经阻滞和收肌管阻滞等区域麻醉技术以其可靠的镇痛效果和较少的全身不良反应在术后镇痛中的应用比例逐渐提高。局部切口浸润的应用也越来越广泛。无论采用哪种方法,重要的临床需求都是改善功能锻炼期间的镇痛效果和充分保留下肢运动功能。临床实践一直在探索一种安全、持久、有效和无运动神经阻滞的镇痛方法,或多种方法的联合应用,因此,现阶段仍鼓励为TKA患者提供多模式镇痛。

Abstract: Perioperative pain management play a critical role in rapid recovery and long term outcome in patient undergoing total knee arthroplasty. With the advancement of peripheral nerve block, technique such as femoral nerve block, sciatic nerve block, abductor canal blockhave play an important role in perioperative pain management. Local infiltration analgesia have also gained popularity. The ultimate goal of perioperative pain management is to ensure analgesia effect and maintain good motor function of lower extremity. We are still in searching of a safe, effective, analgesia without motor block. Currently multimodal analgesia seems to be the most favorable choice.