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New and Common Perioperative Pain Management Techniques in Total Knee Arthroplasty

机译:全膝关节置换术中常见的围手术期疼痛处理新技术

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Optimal pain control in patients undergoing total knee arthroplasty (TKA) is imperative for good rehabilitation and functional outcomes. However, despite technological advancements, surgeons continue to struggle with adequate pain management in their patients. Current modalities in use, such as patient-controlled analgesia, opioids, and epidural anesthetics, provide good pain relief but can be associated with side effects and serious complications. As a result, newer pain control modalities have been used to try to reduce the use of opioids while providing adequate pain relief. Currently, there are no clear guidelines or evidence for an optimum postoperative TKA analgesic regimen. Our aim was to evaluate the recent literature and provide a summary of the newer perioperative analgesic modalities. Evidence suggests that analgesics, such as newer oral medications, peripheral nerve blocks, and periarticular injections, may improve pain management, rehabilitation, and patient satisfaction, as well as reduce opioid consumption. The literature has also highlighted that a multimodal approach to pain management may provide the best results. However, determining which modalities provide superior pain control is still being extensively studied, and further research is needed.
机译:进行全膝关节置换术(TKA)的患者最佳的疼痛控制对于良好的康复和功能结局至关重要。然而,尽管技术进步,外科医生仍在为患者提供充分的疼痛管理方面挣扎。目前使用的方式,例如患者自控镇痛,阿片类药物和硬膜外麻醉药,可以很好地缓解疼痛,但可能会带来副作用和严重的并发症。结果,已经使用较新的疼痛控制方式来尝试减少阿片类药物的使用,同时提供足够的疼痛缓解。目前,尚无明确的指南或证据表明最佳的术后TKA镇痛方法。我们的目的是评估最近的文献,并对围手术期较新的镇痛方法进行总结。有证据表明,止痛药(例如更新的口服药物,周围神经阻滞和关节周围注射)可改善疼痛管理,康复和患者满意度,并减少阿片类药物的消耗。文献还强调了疼痛治疗的多模式方法可能会提供最佳结果。但是,仍在广泛地研究确定哪种模式可以提供优异的疼痛控制,并且需要进一步的研究。

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