Total knee replacement surgery during perioperative period the progress of multi-modal analgesia.docVIP

 PAGE \* MERGEFORMAT 18 Total knee replacement surgery during perioperative period the progress of multi-modal analgesia [Keywords:] artificial total knee replacement surgery Total knee replacement surgery (total knee arthroplasty, TKA) commonly used in the treatment of end-stage knee joint disease, reduce pain, improve function, correct deformities, but the local damage, and will be an early postoperative rehabilitation exercises, so perioperative pain common. In order to ensure recovery of joint function and reduce postoperative complications, minimally invasive technique alone is not enough, need to exercise the functions under the full pain. TKA perioperative analgesic dosage of a single agent in large, more adverse reactions. Multi-modal analgesia, the application of two or more different mechanisms of the analgesic drug or method of acting on pain receptors, or conduction of the different levels to reduce the amount of a single medicine to prevent a single adverse reactions caused by drug overdose. The exact effect of opioid analgesia, but often accompanied by excessive sedation, nausea and vomiting, hypotension and respiratory depression and other adverse reactions. Recently. TKA types of perioperative analgesic increased, such as non-steroidal anti-inflammatory drugs (NSAIDs), N  methyl  D  aspartate (NMDA) receptor antagonists, local anesthetics and so on, can be oral, muscle injection, intravenous, joint local infiltration, peripheral nerve block, spinal, epidural route was used. Of which the administration of epidural and peripheral nerve block of the most precise. This article aims to compare the various multi-modal analgesic drugs, methods of perioperative analgesia for TKA choice of reference. Theoretical basis for more than one mode of analgesia Involved in pain perception and the incoming multi-dimensional anatomical structure and the pain signal transduction pathway. Surgical local tissue damage, causing the release of inflammator