Perioperative analgesia in total knee replacement:multimodal analgesia schemes and optimal pain management / 中国组织工程研究

ABSTRACT

BACKGROUND:Positive treatment of perioperative analgesia after total knee arthroplasty can accelerate recovery of joint function, reduce complications after replacement, and improve overal technical evaluation of total knee arthroplasty. ＜br> OBJECTIVE:To summarize commonly used analgesic drugs and analgesia method of total knee arthroplasty. ＜br> METHODS:A computer-based online research of Wanfang database and PubMed database was performed to col ect articles published between 1994 and 2014 with the keywords of“total knee replacement, epidural analgesia, peripheral nerve block, joint local analgesia, patient control ed analgesia, cold treatment”in Chinese and English. ＜br> RESULTS AND CONCLUSION:There were 986 articles after the initial survey. Final y, 55 articles were included according to the inclusion and exclusion criteria. As the technology for total knee arthroplasty, early functional rehabilitation and replacement of pain control has been widely concerned, a large number of literatures about analgesic drugs and analgesic programs emerge. Analgesic drugs include opioids, non-steroidal anti-inflammatory drugs, local anesthetics and N-methyl-aspartate receptor blockers. Analgesic program includes epidural analgesia, peripheral nerve blockage, joint local analgesia, patient-control ed analgesia and cold therapy. These analgesic drugs and methods have their advantages and disadvantages. At present, multimodal analgesia schemes have been recognized, but the optimal pain management scheme remains controversial. Increasing considerations should be paid on the choice of analgesic methods, depending on individual characteristics and existing technology.