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Orthopade ; 35(2): 153-61, 2006 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-16362138

RESUMO

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.


Assuntos
Analgésicos/administração & dosagem , Artralgia/tratamento farmacológico , Artralgia/prevenção & controle , Artroplastia do Joelho/efeitos adversos , Prótese do Joelho/efeitos adversos , Bloqueio Nervoso/métodos , Assistência Perioperatória/métodos , Artroplastia do Joelho/métodos , Humanos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Falha de Prótese
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