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: 7605458
• 负责人: Linda T Le
• 金额: $ 3.62万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-12-23 至 2007-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7605458
• 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.

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