PCI efektivitāte kā palīglīdzekļa pie AKB ceļa locītavas endoprotezēšanas pēcoperācijas analgēzijā
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Date
2020
Authors
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Sāpes pēc ceļa locītavas endoprotezēšanas parasti ir stipras un grūti kūpējāmas, tas samazina pacientu mobilitāti, palielina hospitalizācijas laiku un komplikāciju risku. Pēdējos gados ceļa locītavu endoprotezēšanas kļūst arvien plašāk izmantotas, tāpēc ārsti visā pasaulē meklē visefektīvāko pretsāpju metodi. Nesen adduktora kanāla bloks (AKB) tika ieviests kā selektīvs sensorais fasciālais bloks pēcoperācijas analgēzijai. AKB neizraisa muskuļu vājumu un var veicināt ātrāku atveseļošanos. Tomēr ir dati, kas liecina, ka AKB neremdē ceļa mugurējas daļas sāpes, tādēļ to sāka kombinēt ar ceļa locītavas mugurējās kapsulas infiltrāciju (posterior capsule infiltration) jeb PCI, kuru veic operējošais traumatologs operācijas laikā pirms kapsulas slēgšanas.
AKB kombinācijā PCI var efektīvāk remdēt posterolaterālās ceļa locītavas sāpes pēc ceļa locītavas endoprotezēšanas, lai pacienti pēc iespējas ātrāk sāktu rehabilitācijas procesu ka arī, lai mazinātu pēcoperācijas infekcijas, venozās trombozes attīstības risku.
Pain after total knee arthroplasty is usually severe and is difficult to manage, it reduces patient mobility, increases the hospitalisation time and the risk of complications. In recent years total joint replacements are gaining popularity, so Doctors around the world are searching for the most efficient analgesic method. Recently, the adductor canal (ACB) was introduced as the selective sensory fascial block for postoperative analgesia. ACB doesn’t cause muscle weakness and may contribute to faster recovery. However, there is evidence indicating that ACB doesn’t relieve pain in the posterior part of the knee capsule and therefore it is combined with the infiltration of the posterior knee capsule (PCI) by operating orthopedic surgeon during surgery prior to the closure of the capsule. ACB combined with posterior capsular infiltration analgesia (PCI) can better reduce posterolateral knee joint pain after total knee arthroplasty in order for the patients to begin rehabilitation exercises as soon as possible to promote functional recovery and reduce the risk of postoperative infection, venous thrombotic events, and joint stiffness.
Pain after total knee arthroplasty is usually severe and is difficult to manage, it reduces patient mobility, increases the hospitalisation time and the risk of complications. In recent years total joint replacements are gaining popularity, so Doctors around the world are searching for the most efficient analgesic method. Recently, the adductor canal (ACB) was introduced as the selective sensory fascial block for postoperative analgesia. ACB doesn’t cause muscle weakness and may contribute to faster recovery. However, there is evidence indicating that ACB doesn’t relieve pain in the posterior part of the knee capsule and therefore it is combined with the infiltration of the posterior knee capsule (PCI) by operating orthopedic surgeon during surgery prior to the closure of the capsule. ACB combined with posterior capsular infiltration analgesia (PCI) can better reduce posterolateral knee joint pain after total knee arthroplasty in order for the patients to begin rehabilitation exercises as soon as possible to promote functional recovery and reduce the risk of postoperative infection, venous thrombotic events, and joint stiffness.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Adduktora kanāla blokāde, mugurējās kapsulas infiltrācija, ceļa locītavas endoprotezēšana, Adductor canal block, posterior capsule block, knee joint replacement