全髋关节置换术后镇痛方式的研究进展

Research Progress of Analgesic Methods after Total Hip Arthroplasty

全髋关节置换术(THA)是最常进行的矫形外科手术之一,其在改善严重髋关节骨性关节炎和股骨头坏死患者的疼痛和关节活动范围方面具有公认的疗效。然而,THA患者在手术后不久会出现中度至重度疼痛,术后疼痛控制不足会对患者的生活质量、功能恢复产生不利影响,并增加术后各种并发症的发生风险,因此良好的术后疼痛管理是THA不可忽视的重要组成部分。目前,阿片类药物是THA后镇痛最常使用的药物,但由于其临床常见的不良反应,THA后疼痛的管理仍面临巨大的挑战。多模式镇痛是目前最常推荐的镇痛策略,但其具体方案仍存在争议,故对于各种镇痛药物和镇痛方式的联合仍需要临床进一步探索。

Total hip arthroplasty(THA)is one of the most commonly performed orthopedic operations.It has a recognized effect in improving the pain and range of motion of joints in patients with severe hip osteoarthritis and femoral head necrosis.However,patients with THA will suffer from moderate to severe pain shortly after operation,and insufficient postoperative pain control will adversely affect the quality of life and functional recovery of the patients,increasing the risk of postoperative complications.Therefore,good postoperative pain management is an important part of THA.At present,opioid drugs are still the most commonly used drugs for analgesia after THA,but due to their common clinical adverse reactions,the management of pain after THA is still facing great challenges.Multimodal analgesia is the most commonly recommended analgesic strategy at present,but its specific plan is still controversial,so the combination of various analgesic drugs and analgesic methods still needs further clinical exploration.