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在膝关节关节整形术中对多模式止痛技术的比较评估:一项比较研究

Arnav P Rathod¹, Yogesh B Rathod¹, Rajendra Baitule¹

¹Department of Orthopedics, Dr. Panjabrao Deshmukh Memorial Medical College Hospital, Amravati, Maharashtra, India.

Journal of orthopaedic case reports

|October 13, 2025

概括

局部透止痛 (LIA) 和添加管道阻塞 (ACB) 在全膝关节整形术 (TKA) 后显著改善术后疼痛管理. 与脂质体布皮瓦卡因的LIA提供了最有效的疼痛缓解和减少阿片类药物使用.

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:

有效的疼痛管理对于全膝关节整形术 (TKA) 后的患者康复和移动性至关重要.
多模式镇痛 (MMA) 策略旨在增强疼痛缓解和减少阿片类药物依赖.
附带管道阻断 (ACB) 和局部透止痛 (LIA) 是先进的MMA技术.

研究的目的:

为了比较标准MMA与MMA结合ACB或LIA用于TKA后疼痛控制的有效性.
评估ACB和LIA对疼痛评分和阿片类药物消费的影响.
评估不同止痛策略的安全性和副作用概况.

主要方法:

一项前性比较研究包括90名接受单边TKA的患者,分为三组:标准MMA,MMA + ACB和MMA + LIA.
使用视觉模拟尺度 (VAS) 评估术后6,12,24和48小时的疼痛.
二次结果指标包括阿片类药物的总消费量和不良事件的发生率.

主要成果:

与标准MMA相比,ACB和LIA都显著降低了VAS疼痛得分 (P < 0.001).
LIA 组 (C 组) 显示疼痛评分最低,并且延迟了需要阿片类药物救援药物的需要.
在ACB和LIA组中,阿片类药物的消费和不良影响明显较低,而LIA显示出最有利的结果.

结论:

附带管道阻塞和局部透止痛是MMA的有效补充,用于改善TKA后的止痛.
局部透止痛与脂质体布皮瓦卡因提供持续的疼痛缓解,支持其整合到增强的恢复协议.
LIA提供了卓越的疼痛管理特征,减少了TKA患者的阿片类药物需求和副作用.

关键词:

整体膝关节关节整形手术输入管道阻塞输入管道阻塞局部透镇痛镇痛局部透多模式止痛药多模式止痛药术后疼痛术后疼痛术后疼痛

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