A Nerve Block?

1. The goal of postoperative pain treatment is to reduce postoperative complications, promote the rehabilitation of patients and improve the effect of surgical treatment through analgesia. PCA technology is a kind of microcomputer analgesia produced by the close combination of computer technology and medicine. It is set by anesthesiologist in advance and a safe amount of painkillers. The patient can control the needed analgesics by pressing and twisting easily, so as to quickly achieve the purpose of postoperative relief or relief of pain. In the late 1990s, it entered China. The route of administration can be transtatic (PCIA), epidural (PCEA), or subcutaneous (PCSA), depending on the patient's condition. The main advantage of PCA is that the drug administration conforms to the pharmacokinetic principle of analgesics, and it is easier to maintain the minimum effective analgesic concentration. The use of pain relievers can be really timely and rapid, and basically solve the individual differences of patients' needs for pain relievers; It is helpful for patients to obtain the best analgesic effect at any time and under different pain intensity. It alleviates the adverse effects caused by pain, such as stress, myocardial ischemia, atelectasis and delayed functional exercise. The drugs used in PCA are mainly opioids and local anesthetics. Clinically, it is usually a low-concentration local anesthetic (such as 0.125% bupivacaine) combined with low-dose opioids (such as fentanyl, morphine, and sufentanil). Ropivacaine, a new local anesthetic, is of special significance in postoperative analgesia because it shows obvious separation of sensory and motor nerve block at low concentration (0.1%-0.2%). In recent years, the concept of "walking epidural analgesia" has been proposed to enable patients to get satisfactory analgesia without affecting lower limb movement and get out of bed early. Common formulations are ropivacaine 0.1% with morphine or fentanyl. It is worth raising the problem of postoperative analgesia in children. The severe pain after operation has a greater impact on the mental health of children, which is not conducive to their mental health development, especially for children who repeatedly undergo orthopaedic surgery. Some experts think that children over 5 years old can be considered for postoperative analgesic treatment.

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