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Updated: May 7, 2025

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整体部和膝关节关节置换术中的疼痛管理:2024年以证据为基础和有争议的实践

Enrico M Forlenza, Denis Nam, Yale A Fillingham

Instructional course lectures

|January 2, 2025

概括

多模式止痛和麻醉是关节置换手术的标准,减少疼痛和阿片类药物的使用. 这种方法结合了各种方法,如口服药物,注射,神经阻塞和不同类型的麻醉.

科学领域:

整形外科手术整形外科手术
麻醉学麻醉学
疼痛管理疼痛管理

背景情况:

多模式止痛和麻醉现在是全面关节整形术的标准.
目标是减少术后疼痛和阿片类药物消费.
尽量减少与阿片类药物相关的并发症是一个关键目标.

研究的目的:

概述一个有效的多模式止痛和麻醉方案的组成部分.
讨论在这种方法中使用的各种药理和非药理干预措施.
突出不同治疗方式的好处和考虑因素.

主要方法:

口服药物的整合 (例如,乙氨基,NSAIDs).
使用周关节注射和区域神经阻塞.
脊柱和全身麻醉技术的应用.
考虑使用 gabapentinoids,SSRI 和皮质类固醇.
包括神经除用于持续性疼痛.

主要成果:

多模式策略有效地减少术后疼痛.
通过这些协议,阿片类药物的消费量显著下降.
与阿片类药物使用相关的并发症被最小化.
皮质类固醇在减少疼痛,阿片类药物使用和恶心/吐方面表现出有效性.

结论:

多模式止痛和麻醉在全关节关节整形术中代表了黄金标准.
一个全面的协议优化了疼痛管理和患者的恢复.
需要仔细选择药物,以平衡疗效和潜在风险.

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