全膝关节置换术围手术期疼痛管理_West China Medical Journal

Authors：

 陈玲敏 ¹ , 张燕姿 ¹ , 宋健楠 ² ,  杨静 ¹

1. ;
2. ;

Corresponding author：

Keywords：

全膝关节置换; 镇痛; 神经阻滞

DOI：

10.7507/1002-0179.20160050

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全膝关节置换术是治疗膝关节终末期病变的重要方式，但术后疼痛严重影响患者的术后康复训练和手术疗效，甚至导致许多并发症。如何有效缓解术后疼痛已经成为临床医生所关注的重要难题。该文将对膝关节置换术后镇痛策略及镇痛方法进行综述。

Citation： 陈玲敏, 张燕姿, 宋健楠, 杨静. 全膝关节置换术围手术期疼痛管理. West China Medical Journal, 2016, 31(1): 180-183. doi: 10.7507/1002-0179.20160050 Copy

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3.	Chen SR, Chen CS, Lin PC. The effect of educational intervention on the pain and rehabilitation performance of patients who undergo a total knee replacement[J]. J Clin Nurs, 2014, 23(1/2):279-287.
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7.	Lewis C, Gunta K, Mitchell K, et al. Effectiveness of multimodal pain management protocol in total knee arthroplasty patients[J]. Orthopaedic Nursing, 2012, 31(3):153-159.
8.	Horlocker TT. Pain management in total joint arthroplasty:a historical review[J]. Orthopedics, 2010, 33(9 Suppl):14-19.
9.	Wheeler M, Oderda GM, Ashburn MA, et al. Adverse events associated with postoperative opioid analgesia:a systematic review[J]. J Pain, 2002, 3(3):159-180.
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12.	Bauer MC, Pogatzki-Zahn EM, Zahn PK. Regional analgesia techniques for total knee replacement[J]. Curr Opin Anaesthesiol, 2014, 27(5):501-506.
13.	Chan EY, Fransen M, Parker DA, et al. Femoral nerve blocks for acute postoperative pain after knee replacement surgery[J]. Cochrane Database Syst Rev, 2014, 5:CD009941.
14.	Bauer M, Wang L, Onibonoje OK, et al. Continuous femoral nerve blocks:decreasing local anesthetic concentration to minimize quadriceps femoris weakness[J]. Anesthesiology, 2012, 116(3):665-672.
15.	Wasserstein D, Farlinger C, Brull R, et al. Advanced age, obesity and continuous femoral nerve blockade are Independent risk factors for inpatient falls after primary total knee arthroplasty[J].J Arthroplasty, 2013, 28(7):1121-1124.
16.	Fowler SJ, Symons J, Sabato S, et al. Epidural analgesia compared with peripheral nerve blockade after major knee surgery:a systematic review and meta-analysis of randomized trials[J]. Br J Anaesth, 2008, 100(2):154-164.
17.	Lund J, Jenstrup MT, Jaeger P, et al. Continuous adductor-canal-blockade for adjuvant post-operative analgesia after major knee surgery:preliminary results[J]. Acta Anaesthesiol Scand, 2011, 55(1):14-19.
18.	Jin SQ, Ding XB, Tong Y, et al. Effect of saphenous nerve block for postoperative pain on knee surgery:a meta-analysis[J]. Int J Clin Exp Med, 2015, 8(1):368-376.
19.	Jaeger P, Nielsen ZJ, Henningsen MH, et al. Adductor canal block versus femoral nerve block and quadriceps strength:a randomized, double-blind, placebo-controlled, crossover study in healthy volunteers[J]. Anesthesiology, 2013, 118(2):409-415.
20.	Jaeger P, Zaric D, Fomsgaard JS, et al. Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty a randomized, double-blind study[J]. Reg Anesth Pain Med, 2013, 38(6):526-532.
21.	Kim DH, Lin Y, Goytizolo EA, et al. Adductor canal block versus femoral nerve block for total knee arthroplasty:a prospective, randomized, controlled trial[J]. Anesthesiology, 2014, 120(3): 540-550.
22.	Cuvillon P, Ripart J, Lalourcey L, et al. The continuous femoral nerve block catheter for postoperative analgesia:bacterial colonization, infectious rate and adverse effects[J]. Anesth Analg, 2001, 93(4):1045-1049.
23.	Ilfeld BM, Madison SJ. The sciatic nerve and knee arthroplasty:to block,or not to block——that is the question[J]. Reg Anesth Pain Med, 2011, 36(5):421-423.
24.	Wegener JT, Van Ooij B, Van Dijk C, et al. Value of single-injection or continuous sciatic nerve block in addition to a continuous femoral nerve block in patients undergoing total knee arthroplasty a prospective, randomized, controlled trial[J]. Reg Anesth Pain Med, 2011, 36(5):481-488.

1. Carr AJ, Robertsson O, Graves S, et al. Knee replacement[J]. Lancet, 2012, 379(9823):1331-1340.
2. Grosu I, Lavand' homme P, Thienpont E. Pain after knee arthroplasty:an unresolved issue[J]. Knee Surg Sports Traumatol Arthrosc, 2014, 22(8):1744-1758.
3. Chen SR, Chen CS, Lin PC. The effect of educational intervention on the pain and rehabilitation performance of patients who undergo a total knee replacement[J]. J Clin Nurs, 2014, 23(1/2):279-287.
4. Dalury DF, Lieberman JR, Macdonald SJ. Current and innovative pain management techniques in total knee arthroplasty[J]. J Bone Joint Surg Am, 2011, 93(20):1938-1943.
5. Buvanendran A, Kroin JS, Tuman KJ, et al. Effects of perioperative administration of a selective cyclooxygenase 2 inhibitor on pain management and recovery of function after knee replacement:a randomized controlled trial[J]. JAMA, 2003, 290(18):2411-2418.
6. Maheshwari AV, Blum YC, Shekhar L, et al. Multimodal pain management after total hip and knee arthroplasty at the Ranawat Orthopaedic Center[J]. Clin Orthop Relat Res, 2009, 467(6): 1418-1423.
7. Lewis C, Gunta K, Mitchell K, et al. Effectiveness of multimodal pain management protocol in total knee arthroplasty patients[J]. Orthopaedic Nursing, 2012, 31(3):153-159.
8. Horlocker TT. Pain management in total joint arthroplasty:a historical review[J]. Orthopedics, 2010, 33(9 Suppl):14-19.
9. Wheeler M, Oderda GM, Ashburn MA, et al. Adverse events associated with postoperative opioid analgesia:a systematic review[J]. J Pain, 2002, 3(3):159-180.
10. Hantler C, Despotis GJ, Sinha R, et al. Guidelines and alternatives for neuraxial anesthesia and venous thromboembolism prophylaxis in major orthopedic surgery[J]. J Arthroplasty, 2004, 19(8): 1004-1016.
11. Marques EM, Jones HE, Elvers KT, et al. Local anaesthetic infiltration for peri-operative pain control in total hip and knee replacement:systematic review and meta-analyses of short- and long-term effectiveness[J]. BMC Musculoskelet Disord, 2014, 15(1):220.
12. Bauer MC, Pogatzki-Zahn EM, Zahn PK. Regional analgesia techniques for total knee replacement[J]. Curr Opin Anaesthesiol, 2014, 27(5):501-506.
13. Chan EY, Fransen M, Parker DA, et al. Femoral nerve blocks for acute postoperative pain after knee replacement surgery[J]. Cochrane Database Syst Rev, 2014, 5:CD009941.
14. Bauer M, Wang L, Onibonoje OK, et al. Continuous femoral nerve blocks:decreasing local anesthetic concentration to minimize quadriceps femoris weakness[J]. Anesthesiology, 2012, 116(3):665-672.
15. Wasserstein D, Farlinger C, Brull R, et al. Advanced age, obesity and continuous femoral nerve blockade are Independent risk factors for inpatient falls after primary total knee arthroplasty[J].J Arthroplasty, 2013, 28(7):1121-1124.
16. Fowler SJ, Symons J, Sabato S, et al. Epidural analgesia compared with peripheral nerve blockade after major knee surgery:a systematic review and meta-analysis of randomized trials[J]. Br J Anaesth, 2008, 100(2):154-164.
17. Lund J, Jenstrup MT, Jaeger P, et al. Continuous adductor-canal-blockade for adjuvant post-operative analgesia after major knee surgery:preliminary results[J]. Acta Anaesthesiol Scand, 2011, 55(1):14-19.
18. Jin SQ, Ding XB, Tong Y, et al. Effect of saphenous nerve block for postoperative pain on knee surgery:a meta-analysis[J]. Int J Clin Exp Med, 2015, 8(1):368-376.
19. Jaeger P, Nielsen ZJ, Henningsen MH, et al. Adductor canal block versus femoral nerve block and quadriceps strength:a randomized, double-blind, placebo-controlled, crossover study in healthy volunteers[J]. Anesthesiology, 2013, 118(2):409-415.
20. Jaeger P, Zaric D, Fomsgaard JS, et al. Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty a randomized, double-blind study[J]. Reg Anesth Pain Med, 2013, 38(6):526-532.
21. Kim DH, Lin Y, Goytizolo EA, et al. Adductor canal block versus femoral nerve block for total knee arthroplasty:a prospective, randomized, controlled trial[J]. Anesthesiology, 2014, 120(3): 540-550.
22. Cuvillon P, Ripart J, Lalourcey L, et al. The continuous femoral nerve block catheter for postoperative analgesia:bacterial colonization, infectious rate and adverse effects[J]. Anesth Analg, 2001, 93(4):1045-1049.
23. Ilfeld BM, Madison SJ. The sciatic nerve and knee arthroplasty:to block,or not to block——that is the question[J]. Reg Anesth Pain Med, 2011, 36(5):421-423.
24. Wegener JT, Van Ooij B, Van Dijk C, et al. Value of single-injection or continuous sciatic nerve block in addition to a continuous femoral nerve block in patients undergoing total knee arthroplasty a prospective, randomized, controlled trial[J]. Reg Anesth Pain Med, 2011, 36(5):481-488.

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