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.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 中心，不一定是研究者的机构。 全髋关节置换术后物理治疗PT的成功很大程度上决定了手术本身的最终成功。 不幸的是，频繁且密集的 PT 常常会导致剧烈疼痛。 疼痛限制了患者可耐受的 PT 质量和数量，以及手术的最终功能结果。 硬膜外输注或静脉阿片类药物可提供有效的镇痛。 然而，两者都需要住院治疗。 此外，硬膜外麻醉与围手术期经常使用的新抗凝剂是禁忌的。低分子肝素。 或者，通过神经周围腰丛导管注入局部麻醉剂可在 THA 后提供有效的镇痛作用。 这些腰肌间隔导管可与新的抗凝剂一起使用，并且不需要患者继续住院。 将这些导管与便携式输液泵相结合，门诊患者可以体验到以前仅向住院患者提供的相同水平的镇痛效果。我们将使用这些技术来研究涉及 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THA入院时间的可行性。 其次，我们将进行一项随机、双盲、安慰剂对照试验，以评估神经周围输注对 PT 和康复期的影响。 我们的次要结果指标包括术后疼痛、口服阿片类药物需求、睡眠障碍、患者满意度、资源利用率和医疗保健成本。