反向全肩关节置换术后疼痛仍较常见，并可能增加阿片类药物使用、延长住院时间、延迟康复并降低患者满意度。 因此，真正需要回答的问题是：反向全肩关节置换术后疼痛管理应如何优化？
下面这篇文献将回答这个问题。
文献英文标题
Pain Management Strategies in Reverse Total Shoulder Arthroplasty.
英文摘要要点
Abstract excerpt: PURPOSE OF REVIEW: Reverse total shoulder arthroplasty (rTSA) is a commonly utilized procedure for rotator cuff arthropathy, irreparable rotator cuff tears, and complex proximal humerus fractures. Although rTSA significantly improves long-term pain and function, postoperative pain remains common and is closely associated with increased opioid consumption, prolonged hospitalization, delayed recovery, and reduced patient satisfaction. Within the modern context of the opioid epidemic, optimizing pain control while minimizing narcotic usage is essential. This review summarizes recent evidence on pain management strategies for rTSAs, with emphasis on regional anesthesia techniques, multimodal analgesia, periarticular injections, Enhanced Recovery After Surgery (ERAS) protocols, and patient-specific factors influencing pain outcomes.
RECENT FINDINGS: Recent studies demonstrate that interscalene nerve blocks provide effective early postoperative analgesia and reduce opioid requirements, though complications such as phrenic nerve paralysis and rebound pain persist. Alternative regional techniques, including combined suprascapular and axillary nerve blocks, could offer comparable analgesia with reduced adverse risks in select patients. Multimodal analgesia protocols consistently decrease opioid consumption, improve early pain scores, and shorten hospital length of stay, although outcomes vary based on regimen composition. Periarticular injections further enhance analgesia when used alone or as adjuncts to regional anesthesia. ERAS protocols are associated with improved postoperative outcomes in hip and knee arthroplasty, but evidence of their application remains limited in rTSA. Patient-level factors, including preoperative opioid use, mental health conditions, and comorbidity burden, strongly predict postoperative pain and prolonged opioid dependence. Postoperative pain management after rTSA has evolved toward a multimodal, patient-centered approach integrating approaches such as regional anesthesia, non-opioid multimodal analgesia, and periarticular injections. Despite recent advances, optimal regional anesthetic techniques and the implementation of standardized ERAS protocols in rTSA remain areas of necessary future investigation.
文献标题中文翻译
反向全肩关节置换术中的疼痛管理策略
文献简介
反向全肩关节置换术常用于肩袖关节病、不可修复肩袖撕裂和复杂近端肱骨骨折等情况。虽然该手术可改善长期疼痛和功能，但术后早期疼痛管理仍是影响康复质量的重要环节。这篇综述聚焦反向全肩关节置换术后的镇痛策略，重点讨论区域麻醉、多模式镇痛、关节周围浸润、加速康复外科流程以及患者个体因素对疼痛结局的影响。