[ERAS Guidelines] THR & TKR 骨科下肢關節置換手術(術前、術中、術後)臨床照顧建議指引

隨著過去15ERAS在全球的推廣,官方針對各個外科別的大型手術照顧建議指引越來越完整。Acta Orthopaedica201910月30日刊登了骨科下肢關節置換手術(Total Hip Replacement & Total Knee ReplacementERAS臨床照顧建議指引ERAS society的專家小組整理了過去的文獻資料,透過實證醫學對17項臨床處置給予 evidence level recommendation grade 的分級。


其中 high evidence level strong recommendation 的包含:

  • Preoperative optimization:術前4週的戒菸
  • Local infiltrative anesthetics within a multi-modal analgesia regimen:多模式止痛下,膝置換手術進行局部麻醉浸潤
  • Prevention of perioperative blood lossTranexamic acid 降低出血量
  • Perioperative oral analgesia:無禁忌的前提下常規使用 NSAIDs
  • Maintaining normothermia:術中及術後維持正常體溫


論文連結:

Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations

Thomas W Wainwright et. al.

Published 30 Oct 2019