骨科上肢手术围术期镇痛的新进展

New progress of upper limb perioperative analgesia

骨科手术术后疼痛给很多患者带来痛苦,特别上肢手术,患者肢体活动不足会引起软组织和肌肉萎缩、肌肉功能退化、骨质疏松及关节僵硬,从而导致患者的生活质量严重受损.围术期上肢手术疼痛治疗,可分为术前、术中和术后3个阶段的个体化多模式镇痛,其目的 是为患者提供更好的镇痛效果,减少单一药品的用量和不良反应,本文对骨科上肢手术围术期镇痛的个体化多模式镇痛概念、疼痛评估方式、各种治疗方式的新进展进行综述,期待对围术期骨科上肢手术疼痛治疗提供一定临床指导意义.

Many patients are still suffering from postoperative pain after the orthopedics operation, especially the up- per limb operation. Extremity underactivity can cause atrophy of parenchyma and muscles, muscle functional deteriora- tion, osteoporosis, and anchylosis. All these side effects can affect patient＇s quality of life. Effective preoperative pain management mainly includes three stage individual pattern of analgesia, which refers to preoperative, intraoperative, and postoperative analgesia. The purpose is to reduce pain in multiple planes and three dimension, strengthen the effect of an- algesics and reduce dosage and side effect of single drug. This paper summarizes new progress on individual - multimode - pattern analgesics, pain assessment method, and various therapies. We hope to provid more effective directions to up- per limb operation.