搜索
1 WHO1979IASP1986[1]1995AmericanPainSocietyAPSJamesCampell“”[2]EnhancedRecoveryAfterSurgery,ERASVisualAnalogueScaleVASNumericalRatingsScaleNRS1VerbaldeDescriptionScaleVDSFPS-R2016-03-0812:52:35 1VAS1234512VASNRS33 4Multi-modelPainManagement[3]++PCA[4]5121NSAIDsNSAIDsCOX-2[5]NSAIDsCOX-2COX-2HuangBuvanendranCOX-2[6,7,8]COX-2NSAIDsNSAIDsNSAIDs24 [9]34NSAIDs34-672[10,11,12]4[13]Meta[14,15]5“”“”[16]“”5 FuBuschMullaji[17-20]“”“”“”6PatientControlledAnalgesiaPCAPCAPatientControlledIntravenousAnalgesiaPCIAPCAPatientControlledEpiduralAnalgesiaPCEAPCAPatientControlledSubcutaneousAnalgesiaPCSAPCIAPCIAPCAPCIA126 31234123“”45COX-251NSAIDsCOX-22PCIA3456NSAIDsCOX-24internationalclassificationofsleep7 disorders,ICSD“”/1.1232.3.1234“ICD-10,InternationalClassificationofDisease”71.302.23.4.605./6.8 “”7.1.2.3.123314.1222125.“”--TSHFT3FT4TT3TT4--ACHTPTCUFCDSTOGTT6.Polysomnography,PSGSLATTSASESMT7.6“”1.“///”“”2.5SSRIs3.4.9 1.FoleyKM,PosnerJB.Painanditsmanagement.In:WyngaardenJB,SmithLH.Ceciltextbookofmedicine.18thed.Philadelphia.WBSaundersCompany,1988.104-112.2.PhilipsWJ,CurrierBL.Analgesicpharmacology:I.Neurophysiology.JAmAcadOrthopSurg,2004;12:213-20.3.ParviziJ,MillerAG,GandhiK.Multimodalpainmanagementaftertotaljointarthroplasty.JBoneJointSurgAm,2011;93(11):1075-84.4.,,,..,2013;21(10):976-80.5.McCartneyCJ,NelliganK.Postoperativepainmanagementaftertotalkneearthroplastyinelderlypatients:treatmentoptions.DrugsAging,2014;31(2):83-91.6.,,,..,2009;47(2):116-9.7.HuangYM,WangCM,WangCT,etal.Perioperativecelecoxibadministrationforpainmanagementaftertotalkneearthroplasty-arandomized,controlledstudy.BMCMusculoskeletDisord,2008;9:77.8.BuvanendranA,KroinJS,TumanKJ,etal.Effectsofperioperativeadministrationofaselectivecyclooxygenase2inhibitoronpainmanagementandrecoveryoffunctionafterkneereplacement:arandomizedcontrolledtrial.JAMA,2003;290(18):2411-8.9.BourneMH.Analgesicsfororthopedicpostoperativepain.AmJOrthop,2004;33(3):128-35.10.CasatiA,OstroffR,CasimiroC,etal.72-hourepiduralinfusionof0.125%levobupivacainefollowingtotalkneereplacement:aprospective,randomized,controlled,multicenterevaluation.ActaBiomed,2008;79:28-35.11.ForsterJG,RosenbergPH.Smalldoseofclonidinemixedwithlow-doseropivacaineandfentanylforepiduralanalgesiaaftertotalkneearthroplasty.BrJAnaesth,2004;93(5):670-7.12.ChoiPT,BhandariM,ScottJ,etal.Epiduralanalgesiaforpainrelieffollowinghiporkneereplacement.CochraneDatabaseSystRev,2003;(3):CD003071.13.deLimaSouzaR,CorreaCH,HenriguesMD,etal.Single-injectionfemoralnerveblockwith10 0.25%ropivacaineor0.25%bupivacaineforpostoperativeanalgesiaaftertotalkneereplacementoranteriorcruciateligamentreconstruction.JClinAnesth,2008;20(7):521-7.14.RichmanJM,LiuSS,CourpasG,etal.Doescontinuousperipheralnerveblockprovidesuperiorpaincontroltoopioids?Ameta-analysis.AnesthAnalg,2006;102(1):248-57.15.FowlerSJ,SymonsJ,SabatoS,etal.Epiduralanalgesiacomparedwithperipheralnerveblockadeaftermajorkneesurgery:asystematicreviewandmeta-analysisofrandomizetrials.BrJAnaesth,2008;100(2):154-64.16.FuP,WuY,WuH,etal.Efficacyofintra-articularcocktailanalgesicinjectionintotalkneearthroplasty-arandomizedcontrolledtrial.Knee,2009;16:280-4.17.,,,..,2013;33(3):246-51.18.FuP,WuH,LiX,etal.Efficacyofintra-articularcocktailanalgesicinjectionintotalkneearthroplasty-arandomizedcontrolledtrial.Knee,2009;16:280-4.19.BuschCA,ShoreBJ,BhandariR,etal.Efficacyofperiarticularmultimodaldruginjectionintotalkneearthroplasty.Arandomizedtrial.JBoneJointSurgAm,2006;88:959-63.20.MullajiA,KannaR,ShettyGM,etal.Efficacyofperiarticularinjectionofbupivacaine,fentanyl,andmethylprednisoloneintotalkneearthroplasty:aprospective,randomizedtrial.JArthroplasty,2010;25:851-7.11 MayoClinic10mg+300mg+1000mg+75mg/200gTKA1000mgq8h75mg/200gbid+300mgq8h5mg/4h2mgiv/2h0.5mgiv/2h50-74.9kg200mg+100g+30mg+5mg75-99.9kg300mg+200g+30mg+5mg100-125kg400mg+300g+30mg+5mgTKA30ml+50ml40mlHospitalforSpecialSurgery(HSS)15mg757.5mg20mg8010mg100g/24h30-60min36530mg6515mg2-4mg15min10mg-20mg/1000mg/6h8h200mg/10d40mg/12 0.5%30ml+8mg/ml1ml+40mg/ml1ml+500mg10ml0.25%40mlMassachusettsGeneralHospital(MGH)200mg400mg/10mg20mg/40mg/100g/24h6h6515mg6530mg2-4mg15min2-4mg2-4h200mg/10d10/20mgq12h48h1000mgq6h40mg/0.5%200-400mg+4-10mg+300g+40mg+750mg+22mlTHATKA200mg+5mg+1:10000.3ml+100mlTKA20ml20ml60ml13 VAS3d200mgbidPCIA24hNSAIDsCOX-25-10mg1SpanehlMJ,ClarkeHD,HentzJG,etal,TheChitranjanRanawatAward:periarticularinjectionsandfemoral&sciaticblocksprovidesimilarpainreliefafterTKA:arandomizedclinicaltrial.ClinOrthopRelatRes,2015:473(1):45-53.2YadeauJT,GoytizoloEA,PadgettDE,etal.Analgesiaaftertotalkneereplacement:localinfiltrationversusepiduralcombinedwithafemoralnerveblockade:aprospective,randomizedpragmatictrial.BoneJointJ,2013;95-B(5):629-35.3ParvataneniHK,ShahVP,HowardH,etal.Controllingpainaftertotalhipandkneearthroplastyusingamultimodelprotocolwithlocalperiarticularinjections:aprospectiverandomizedstudy.JArthroplasty,2007;22(6Suppl2):33-8.4,,,..,2010;90(37):2593-6.5,,,..,2013