全髋关节置换围手术期镇痛的研究进展
|
摘要
随着我国人口老年化的进展,髋部骨折发生率逐年增加,而全髋关节置换是目前主要的治疗手段,但术后常见患肢疼痛,老年患者生理功能衰退,创伤疼痛刺激可诱发或加重原有基础疾病,增加围手术期风险。因此,在围手术期对患肢进行安全有效的疼痛管理尤为重要。但目前临床上应用的镇痛方式诸多,临床医生需熟悉不同方式间的优劣,根据患者的实际情况,优化镇痛治疗方案,以促进患者髋关节功能的恢复,缩短住院时间,减少并发症的发生。
With the development of population aging in China, the incidence of hip fracture has increased year by year. The total hip arthroplasty is the main treatment at present. However,postoperative limb pain is common, Traumatic pain stimulation can induce or aggravate the original underlying disease and increase the perioperative risk,due to senile patients' physiological function decline. Therefore, safe and effective pain-control management during the perioperative period is particularly important. Whereas in clinical practice there are many methods to control pain, clinicians need to be familiar with the advantages and disadvantages of vary management, and optimize the analgesic treatment plan, according to the actual situation of patients, to promote the recovery of hip function, shorten the length of hospital stay and reduce complications.
With the development of population aging in China, the incidence of hip fracture has increased year by year. The total hip arthroplasty is the main treatment at present. However,postoperative limb pain is common, Traumatic pain stimulation can induce or aggravate the original underlying disease and increase the perioperative risk,due to senile patients' physiological function decline. Therefore, safe and effective pain-control management during the perioperative period is particularly important. Whereas in clinical practice there are many methods to control pain, clinicians need to be familiar with the advantages and disadvantages of vary management, and optimize the analgesic treatment plan, according to the actual situation of patients, to promote the recovery of hip function, shorten the length of hospital stay and reduce complications.
引文
[1]Horlocker T T.Pain management in total joint arthroplasty:a historical review[J].Orthopedics,2010,33(Sup9):14.
[2]Divella M,Cecconi M,Fasano N,et al.Pain relief after total hip replacement:oral CR oxycodone plus IV paracetamol versus epidural levobupivacaine and sufentanil.Arandomized controlled trial[J].Minerva Anestesiologica,2012,78(5):534.
[3]马元琛,廖俊星,顾宏林,等.无痛病房管理对全髋关节置换术后疼痛控制的效果评价[J].中华关节外科杂志(电子版),2014(2):147-150.
[4]Moyer R,Ikert K,Long K,et al.The Value of Preoperative Exercise and Education for Patients Undergoing Total Hip and Knee Arthroplasty:A Systematic Review and MetaAnalysis[J].JBJS Rev.2017,5(12):e2.
[5]段善平,胡兰平,朱红珍,等.多媒体视频宣教用于髋关节置换术患者康复训练效果的Meta分析[J].中华现代护理杂志,2017(6):832-836.
[6]黄萍,何洁,张玉梅.手机病患管理应用程序在膝关节置换患者宣教和随访中的应用[J].中华医学杂志,2017,97(20):1592-1595.
[7]George W,Crile MD.The kinetic theory of shock and its prevention through anoci-association(shockless operation)[J].Lancet,1913,182(4688):7-16.
[8]张倩,尤浩军.“超前镇痛”研究进展及麻醉中应用[J].中国疼痛医学杂志,2016,22(4):241-244.
[9]Moreira A.Preemptive analgesia for postoperative pain control:is it possible[J].International Journal for Numerical Methods in Fluids,2015,72(4):478-504.
[10]徐丽丽,沈建军,周海燕.超前镇痛的临床研究进展[J].上海医学,2012,35(4):345-349.
[11]Kerr DR,Kohan L.Local infiltration analgesia:a technique for the control of acute postoperative pain following knee and hip surgery:a case study of 325patients[J].Acta Orthopaedica,2008,79(2):174-183.
[12]Wang Y,Gao F,Wei S,et al.The efficacy of periarticular drug infiltration for postoperative pain after total hip arthroplasty:A systematic review and meta-analysis[J].Medicine,2017,96(12):e6401.
[13]Nakai T,Nakamura T,Nakai T,et al.A study of the usefulness of a periarticular multimodal drug cocktail injection for pain management after total hip arthroplasty[J].Journal of Orthopaedics,2013,10(1):5-7.
[14]Andersen KV,Nikolajsen L,Daugaard H,et al.Local infiltration analgesia is not improved by postoperative intra-articular bolus injections for pain after total hip arthroplasty[J].Acta Orthopaedica,2015,86(6):647-653.
[15]Feenstra P,Brunsteiner M,Khinast J.Prediction of drugpackaging interactions via molecular dynamics(MD)simulations[J].International Journal of Pharmaceutics,2012,431(1-2):26-32.
[16]鲁义,屠伟峰,尧新华,等.两种术后镇痛方式对老年髋关节置换术患者炎性因子表达的影响[J].实用医学杂志,2014(23):3755-3758.
[17]瞿玉莲,杨海峰,陈建树,等.髋关节置换术后老年患者自控镇痛对炎症水平的影响[J].中华医院感染学杂志,2013,23(21):5188-5190.
[18]鲁义,屠伟峰,卿朝晖,等.静脉与硬膜外自控镇痛对老年髋关节置换术患者术后镇静、舒适度及并发症影响的比较[J].临床麻醉学杂志,2015,31(2):109-112.
[19]孙晓娟,张红星,董补怀,等.连续髂筋膜阻滞和硬膜外阻滞下行全髋置换后镇痛的比较[J].中国组织工程研究,2014(31):4934-4938.
[20]Gadsden J,Warlick A.Regional anesthesia for the trauma patient:improving patient outcomes[J].Local&Regional Anesthesia,2015,8:45-55.
[21]Haque M,Yap G.Continuous peripheral nerve blocks for postoperative pain[J].British Journal of Hospital Medicine,2016,77(Sup10):606-606.
[22]Guay J,Parker MJ,Griffiths R,et al.Peripheral Nerve Blocks for Hip Fractures:A Cochrane Review[J].Anesthesia and Analgesia,2018,126(5):1695-1704.
[23]Reavley P,Montgomery AA,Smith JE,et al.Randomised trial of the fascia iliaca block versus the‘3-in-1’block for femoral neck fractures in the emergency department[J].Emergency Medicine Journal,2015,32(9):685-689.
[24]Brandon R,Paul P,Woo MY,et al.Regional Nerve Blocks For Hip and Femoral Neck Fractures in the Emergency Department:A Systematic Review[J].Canadian Journal of Emergency Medicine,2016,18(1):37-47.
[25]Centre NCG.The Management of Hip Fracture in Adults[J].2011,62(10):3491-3492.
[26]Roland A,Flores.3-in-1 block:are we still using this misnomer?[J].Aana Journal,2013,81(3):171.
[27]王宁,李民,魏越,等.超声引导髂筋膜间隙阻滞两种穿刺方式对全髋关节置换术后镇痛效果影响的随机对照研究[J].中华医学杂志,2015,95(28):2277-2281.
[28]Gupta G,Radhakrishna M,Tamblyn I,et al.A randomized comparison between neurostimulation and ultrasoundguided lateral femoral cutaneous nerve block[J].U.S.Army Medical Department Journal,2017(2-17):33-38.
[29]赵远莲,肖庆帮,蒋智钢,等.不同冰敷方式对急性闭合性软组织损伤处理效果的影响[J].中国现代医学杂志,2016,26(20):1-5.
[30]崔鹏,姜文学,范猛,等.人工全髋关节置换术后冰毯机物理降温临床疗效观察[J].天津医科大学学报,2012,18(1):100-101.
[31]任雪玲.自制新型冰敷固定带用于人工全髋关节置换术后冰敷的效果观察[J].中国卫生标准管理,2017,8(20):178-180.
[32]Bech M,Moorhen J,Cho M,et al.Device or Ice:The Effect of Consistent Cooling Using a Device Compared with Intermittent Cooling Using an Ice Bag after Total Knee Arthroplasty[J].Physiotherapy Canada,2015,67(1):48-55.
[33]Pan L,Hou D,Liang W,et al.Comparison the effects of pressurized salt ice packs with water ice packs on patients following total knee arthroplasty[J].Int J Clin Exp Med,2015,8(10):18179-18184.
[34]樊星,赵海燕,崔立敏.中医护理在老年人工全髋关节置换术病人中的应用[J].时珍国医国药,2014(9):2195-2196.
[35]林统,徐强,包海燕.闭合复位经皮空心加压螺钉内固定联合口服中药治疗股骨颈骨折[J].中医正骨,2015(7):61-62.
[36]余志勇,温建民,张云飞.中医骨折三期辨证体系在现代骨科手术后的运用与挑战[J].中华中医药杂志,2017(10):4592-4594.
[37]屈庆,张宏,张国辉.推拿法舒经通络效应机制浅析[J].辽宁中医杂志,2015(3):598-600.
[38]YouNa,Kim,Inja.Comparison of the Effects of Hand Massage Provided with Different Intervals and Periods on Pain and Sleep Disturbance after Orthopedic Surgery[J].Diseases of the Colon&Rectum,2015,18(2):128-134.
[39]Romoli M,Allais G,Airola G,et al.Ear acupuncture and f MRI:a pilot study for assessing the specificity of auricular points[J].Neurological Sciences,2014,35(1):189-193.
[40]Goertz CM,Niemtzow R,Burns SM,et al.Auricular acupuncture in the treatment of acute pain syndromes:A pilot study[J].Military Medicine,2006,171(10):1010-1014.
[41]Tsai SL,Fox LM,Murakami M,et al.Auricular Acupuncture in Emergency Department Treatment of Acute Pain[J].Annals of Emergency Medicine,2016,68(5):583-585.
[42]Parvizi J,Miller AG,Gandhi K.Multimodal pain management after total joint arthroplasty[J].J Bone Joint Surg Am,2011,93(11):1075-1084.
[43]Roberts KC,Brox WT,Jevsevar DS,et al.Management of hip fractures in the elderly[J].JAAOS,2015,23(2):131-137.
[44]Kang H,Ha YC,Kim JY,et al.Effectiveness of multimodal pain management after bipolar hemiarthroplasty for hip fracture:a randomized,controlled study[J].J Bone Joint Surg Am,2013,95(4):291-296.
[45]Young A,Buvanendran A.Recent advances in multimodal analgesia[J].Anesthesiology Clinics,2012,30(1):91-100.
[2]Divella M,Cecconi M,Fasano N,et al.Pain relief after total hip replacement:oral CR oxycodone plus IV paracetamol versus epidural levobupivacaine and sufentanil.Arandomized controlled trial[J].Minerva Anestesiologica,2012,78(5):534.
[3]马元琛,廖俊星,顾宏林,等.无痛病房管理对全髋关节置换术后疼痛控制的效果评价[J].中华关节外科杂志(电子版),2014(2):147-150.
[4]Moyer R,Ikert K,Long K,et al.The Value of Preoperative Exercise and Education for Patients Undergoing Total Hip and Knee Arthroplasty:A Systematic Review and MetaAnalysis[J].JBJS Rev.2017,5(12):e2.
[5]段善平,胡兰平,朱红珍,等.多媒体视频宣教用于髋关节置换术患者康复训练效果的Meta分析[J].中华现代护理杂志,2017(6):832-836.
[6]黄萍,何洁,张玉梅.手机病患管理应用程序在膝关节置换患者宣教和随访中的应用[J].中华医学杂志,2017,97(20):1592-1595.
[7]George W,Crile MD.The kinetic theory of shock and its prevention through anoci-association(shockless operation)[J].Lancet,1913,182(4688):7-16.
[8]张倩,尤浩军.“超前镇痛”研究进展及麻醉中应用[J].中国疼痛医学杂志,2016,22(4):241-244.
[9]Moreira A.Preemptive analgesia for postoperative pain control:is it possible[J].International Journal for Numerical Methods in Fluids,2015,72(4):478-504.
[10]徐丽丽,沈建军,周海燕.超前镇痛的临床研究进展[J].上海医学,2012,35(4):345-349.
[11]Kerr DR,Kohan L.Local infiltration analgesia:a technique for the control of acute postoperative pain following knee and hip surgery:a case study of 325patients[J].Acta Orthopaedica,2008,79(2):174-183.
[12]Wang Y,Gao F,Wei S,et al.The efficacy of periarticular drug infiltration for postoperative pain after total hip arthroplasty:A systematic review and meta-analysis[J].Medicine,2017,96(12):e6401.
[13]Nakai T,Nakamura T,Nakai T,et al.A study of the usefulness of a periarticular multimodal drug cocktail injection for pain management after total hip arthroplasty[J].Journal of Orthopaedics,2013,10(1):5-7.
[14]Andersen KV,Nikolajsen L,Daugaard H,et al.Local infiltration analgesia is not improved by postoperative intra-articular bolus injections for pain after total hip arthroplasty[J].Acta Orthopaedica,2015,86(6):647-653.
[15]Feenstra P,Brunsteiner M,Khinast J.Prediction of drugpackaging interactions via molecular dynamics(MD)simulations[J].International Journal of Pharmaceutics,2012,431(1-2):26-32.
[16]鲁义,屠伟峰,尧新华,等.两种术后镇痛方式对老年髋关节置换术患者炎性因子表达的影响[J].实用医学杂志,2014(23):3755-3758.
[17]瞿玉莲,杨海峰,陈建树,等.髋关节置换术后老年患者自控镇痛对炎症水平的影响[J].中华医院感染学杂志,2013,23(21):5188-5190.
[18]鲁义,屠伟峰,卿朝晖,等.静脉与硬膜外自控镇痛对老年髋关节置换术患者术后镇静、舒适度及并发症影响的比较[J].临床麻醉学杂志,2015,31(2):109-112.
[19]孙晓娟,张红星,董补怀,等.连续髂筋膜阻滞和硬膜外阻滞下行全髋置换后镇痛的比较[J].中国组织工程研究,2014(31):4934-4938.
[20]Gadsden J,Warlick A.Regional anesthesia for the trauma patient:improving patient outcomes[J].Local&Regional Anesthesia,2015,8:45-55.
[21]Haque M,Yap G.Continuous peripheral nerve blocks for postoperative pain[J].British Journal of Hospital Medicine,2016,77(Sup10):606-606.
[22]Guay J,Parker MJ,Griffiths R,et al.Peripheral Nerve Blocks for Hip Fractures:A Cochrane Review[J].Anesthesia and Analgesia,2018,126(5):1695-1704.
[23]Reavley P,Montgomery AA,Smith JE,et al.Randomised trial of the fascia iliaca block versus the‘3-in-1’block for femoral neck fractures in the emergency department[J].Emergency Medicine Journal,2015,32(9):685-689.
[24]Brandon R,Paul P,Woo MY,et al.Regional Nerve Blocks For Hip and Femoral Neck Fractures in the Emergency Department:A Systematic Review[J].Canadian Journal of Emergency Medicine,2016,18(1):37-47.
[25]Centre NCG.The Management of Hip Fracture in Adults[J].2011,62(10):3491-3492.
[26]Roland A,Flores.3-in-1 block:are we still using this misnomer?[J].Aana Journal,2013,81(3):171.
[27]王宁,李民,魏越,等.超声引导髂筋膜间隙阻滞两种穿刺方式对全髋关节置换术后镇痛效果影响的随机对照研究[J].中华医学杂志,2015,95(28):2277-2281.
[28]Gupta G,Radhakrishna M,Tamblyn I,et al.A randomized comparison between neurostimulation and ultrasoundguided lateral femoral cutaneous nerve block[J].U.S.Army Medical Department Journal,2017(2-17):33-38.
[29]赵远莲,肖庆帮,蒋智钢,等.不同冰敷方式对急性闭合性软组织损伤处理效果的影响[J].中国现代医学杂志,2016,26(20):1-5.
[30]崔鹏,姜文学,范猛,等.人工全髋关节置换术后冰毯机物理降温临床疗效观察[J].天津医科大学学报,2012,18(1):100-101.
[31]任雪玲.自制新型冰敷固定带用于人工全髋关节置换术后冰敷的效果观察[J].中国卫生标准管理,2017,8(20):178-180.
[32]Bech M,Moorhen J,Cho M,et al.Device or Ice:The Effect of Consistent Cooling Using a Device Compared with Intermittent Cooling Using an Ice Bag after Total Knee Arthroplasty[J].Physiotherapy Canada,2015,67(1):48-55.
[33]Pan L,Hou D,Liang W,et al.Comparison the effects of pressurized salt ice packs with water ice packs on patients following total knee arthroplasty[J].Int J Clin Exp Med,2015,8(10):18179-18184.
[34]樊星,赵海燕,崔立敏.中医护理在老年人工全髋关节置换术病人中的应用[J].时珍国医国药,2014(9):2195-2196.
[35]林统,徐强,包海燕.闭合复位经皮空心加压螺钉内固定联合口服中药治疗股骨颈骨折[J].中医正骨,2015(7):61-62.
[36]余志勇,温建民,张云飞.中医骨折三期辨证体系在现代骨科手术后的运用与挑战[J].中华中医药杂志,2017(10):4592-4594.
[37]屈庆,张宏,张国辉.推拿法舒经通络效应机制浅析[J].辽宁中医杂志,2015(3):598-600.
[38]YouNa,Kim,Inja.Comparison of the Effects of Hand Massage Provided with Different Intervals and Periods on Pain and Sleep Disturbance after Orthopedic Surgery[J].Diseases of the Colon&Rectum,2015,18(2):128-134.
[39]Romoli M,Allais G,Airola G,et al.Ear acupuncture and f MRI:a pilot study for assessing the specificity of auricular points[J].Neurological Sciences,2014,35(1):189-193.
[40]Goertz CM,Niemtzow R,Burns SM,et al.Auricular acupuncture in the treatment of acute pain syndromes:A pilot study[J].Military Medicine,2006,171(10):1010-1014.
[41]Tsai SL,Fox LM,Murakami M,et al.Auricular Acupuncture in Emergency Department Treatment of Acute Pain[J].Annals of Emergency Medicine,2016,68(5):583-585.
[42]Parvizi J,Miller AG,Gandhi K.Multimodal pain management after total joint arthroplasty[J].J Bone Joint Surg Am,2011,93(11):1075-1084.
[43]Roberts KC,Brox WT,Jevsevar DS,et al.Management of hip fractures in the elderly[J].JAAOS,2015,23(2):131-137.
[44]Kang H,Ha YC,Kim JY,et al.Effectiveness of multimodal pain management after bipolar hemiarthroplasty for hip fracture:a randomized,controlled study[J].J Bone Joint Surg Am,2013,95(4):291-296.
[45]Young A,Buvanendran A.Recent advances in multimodal analgesia[J].Anesthesiology Clinics,2012,30(1):91-100.