IMPROVING POSTOPERATIVE REHABILITATION FOLLOWING TOTAL HIP ARTHROPLASTY WITH PEN

使用笔改善全髋关节置换术后的康复

• 批准号: 7717083
• 负责人: Linda T Le
• 金额: $ 0.68万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-12-01 至 2008-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7717083
• 关键词: Absence of pain sensation; Admission activity; Analgesics; Anticoagulants; Arthroplasty; Catheters; Client satisfaction; Computer Retrieval of Information on Scientific Projects Database; Funding; Grant; Health Care Costs; Hip region structure; Hospitalization; Hospitals; Infusion Pumps; Infusion procedures; Institution; Intravenous; Local Anesthetics; Low-Molecular-Weight Heparin; Lumbar plexus structure; Operative Surgical Procedures; Opioid; Oral; Outcome Measure; Outpatients; Pain; Patients; Perioperative; Physical therapy; Pilot Projects; Postoperative Pain; Postoperative Period; Randomized; Rehabilitation therapy; Research; Research Personnel; Resources; Sleep disturbances; Source; Techniques; United States National Institutes of Health; cohort; double-blind placebo controlled trial; experience; functional outcomes; improved; perineural; prospective; success

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Successful physical therapy PT following total hip arthroplasty THA greatly determines the ultimate success of the surgery itself. Unfortunately, the frequent and intensive PT often results in severe pain. Pain limits the quality and quantity of PT patients can tolerate, and the ultimate functional outcome of the surgery. Effective analgesia may be provided with epidural infusion or intravenous opioids. However, both require hospitalization. Furthermore, epidurals are contraindicated with new anticoagulants often given in the perioperative period e.g. low molecular weight heparin. Alternatively, local anesthetic infused via a perineural lumbar plexus catheter provides potent analgesia following THA. These psoas compartment catheters may be used with new anticoagulants and do not require patients to remain hospitalized. Combining these catheters with portable infusion pumps, outpatients may experience the same level of analgesia previously afforded only to those remaining hospitalized. We will use these techniques to investigate two major questions involving THA. First, we will conduct a prospective cohort pilot study to evaluate the feasibility of shortening THA hospital admission. Second, we will conduct a randomized, double-blinded, placebo-controlled trial to evaluate the effects of perineural infusion on PT and the rehabilitation period. Our secondary outcome measures will include postoperative pain, oral opioid requirements, sleep disturbances, patient satisfaction, resource utilization, and health-care costs.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 总体髋关节置换术后成功的物理疗法PT极大地决定了手术本身的最终成功。 不幸的是，频繁而密集的PT通常会导致严重的疼痛。 疼痛限制了PT患者的质量和数量，并且手术的最终功能结果。 有效的镇痛性可提供硬膜外输注或静脉注射阿片类药物。 但是，都需要住院。 此外，在围手术期间经常给出的新抗凝剂禁用硬尿剂，例如低分子量肝素。 或者，通过周围腰椎神经丛导管通过局部麻醉液在THA后提供有效的镇痛。 这些PSOA隔室导管可以与新的抗凝剂一起使用，并且不需要患者住院。 将这些导管与便携式输液泵相结合，门诊病人可能只有以前仅适用于剩余住院的镇痛药。我们将使用这些技术研究涉及THA的两个主要问题。 首先，我们将进行一项前瞻性队列试点研究，以评估缩短医院入院的可行性。 其次，我们将进行一项随机，双盲的安慰剂对照试验，以评估周围输注对PT和康复期的影响。 我们的次要结局措施将包括术后疼痛，口服阿片类药物要求，睡眠障碍，患者满意度，资源利用和医疗费用。