Schmerzmanagement auf chirurgischen Bettenstationen Qualität und Optimierbarkeit frühpostoperativer Schmerzbetreuung

Total knee arthroplasty (TKA) is associated with significant postoperative pain. Adequate analgesics and techniques are required for early mobilization, continuous passive motion and intensified physical therapy as well as for high-quality postoperative analgesia.However, in the immediate postoperative setting the excessive nociceptive input can be blocked by using doses which are most frequently associated with adverse effects like dizziness, nausea and vomiting, sedation and risk of respiratory depression. The use of peripheral nerve blocks is recommended after orthopaedic surgery. After TKA, the continuous "3 in 1 nerve block" has been proven to be more effective than conventional patient controlled intravenous opioid therapy as well as than epidural analgesia accompanied by side effects. Postoperative analgesic techniques influence surgical outcome, duration of hospitalization and re-convalescence. The use of regional analgesia after TKA may initially lead to higher costs but it is counterbalanced by a reduction in morbidity and mortality, decrease in hospitalization, improved re-convalescence and a better functional outcome.

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A multimodal and multidisciplinary postoperative pain management concept

Ettrich

Seifert

Scharnagel

et al. 2007

Orthopäde

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Under-treatment of acute postoperative pain can lead to chronic pain with neuronal plasticity and result in poor surgical outcomes. A multimodal approach is therefore necessary to reduce postoperative pain by combining various analgesics with a non-pharmacological strategy. The current use of multimodal approaches, even for the management of postoperative pain, can reduce the side effects of pharmaceutical therapy alone as well as reducing the length of hospital stay. Adequate pain control is an important prerequisite for the application of rehabilitation programmes and will thereby influence functional outcome. In addition, patient satisfaction, as a major benchmarking factor after surgical treatment, is significantly influenced by the quality of postoperative pain management.

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Schmerzmanagement auf chirurgischen Bettenstationen Qualität und Optimierbarkeit frühpostoperativer Schmerzbetreuung

Cited by 8 publications

References 30 publications

Qualitätsmanagement der postoperativen Schmerztherapie

Qualitätsmanagement der postoperativen Schmerztherapie

Perioperative Schmerztherapie in der Kniegelenkendoprothetik

A multimodal and multidisciplinary postoperative pain management concept

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