Pain Management and Anesthesia in Total Knee Arthroplasty

Song, Sang Jun

doi:10.5792/ksrr.17.077

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…Table 1 outlines the techniques utilized for multi-modal pain management therapies for the orthopedic surgery patient which often include NSAIDS such as aspirin, naproxen, ketorolac, celecoxib, meloxicam, diclofenac, and ibuprofen (Donahue, Bradbury, Zychowicz, & Muckler, 2018; Brooks, Fretter, Bowles, & Amirault, 2017; Song, 2017; Canata, Casale, & Chiey, 2016; Chou, et al, 2016; ASA 2012). Analgesia resulting from NSAID administration is due to inhibited synthesis and release of prostaglandins and inhibited cyclooxygenase 2 (COX-2) that results in a suppressed inflammatory response (Elmallah, et al, 2018).…”

Section: Modalities and Techniques For Perioperative Pain Management-mentioning

confidence: 99%

Multimodal Pain Management for Major Joint Replacement Surgery

Goode

Morgan

Muckler

et al. 2019

Orthopaedic Nursing

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Effective pain management for orthopedic major joint replacement is key to achieving earlier recovery, better functioning, and high rates of patient satisfaction. In an effort to decrease opioid dependency, practitioners are turning to multimodal pain management, which involves the use of multiple analgesic agents and techniques. In order to utilize this technique, a patient’s history of and preoperative consumption of medications to treat pain impacts the success of this regimen. Multimodal pain management involves the use of NSAIDS, acetaminophen, NMDA antagonists, gabapentin, serotonin inhibitors, regional techniques and opioids as needed. It is necessary for the nurse to understand the mechanism of pain and how the multimodal adjuncts target the pain response in order to benefit the patient’s perioperative course as well as their postoperative and discharge management.

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Section: Modalities and Techniques For Perioperative Pain Management-mentioning

confidence: 99%

Multimodal Pain Management for Major Joint Replacement Surgery

Goode

Morgan

Muckler

et al. 2019

Orthopaedic Nursing

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“…Efficient and immediate postoperative pain management is important to promote better functional recovery, improve patient satisfaction, and reduce the rate of chronic postoperative pain. [ 1 2 ] Despite the evolvement of analgesic modalities, pain control post-TKA remains a challenge for surgeons and patients. There is no standardized protocol for pain management post-TKA.…”

Section: Introductionmentioning

confidence: 99%

“…Traditionally, intravenous patient-controlled analgesia (PCA), continuous epidural infusion, and parenteral and oral opioids were used for postoperative pain control. [ 1 2 3 ] However, there has been a major move towards multimodal analgesia, using a peripheral nerve blockade and local infiltration analgesia to minimize opioid-related adverse effects following surgery. Femoral nerve block (FNB) and adductor canal catheter block (ACB) are the most frequently used peripheral nerve blockade methods.…”

Section: Introductionmentioning

confidence: 99%

Adductor canal catheter block after total knee arthroplasty in patients with severe osteoarthritis and limited mobility. A single center study in Riyadh, Saudi Arabia

Alsebayel

Alturki

Alsheikh

et al. 2022

Saudi Journal of Anaesthesia

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Purpose: Total knee arthroplasty (TKA) is one of the most performed procedures. Postoperative pain control is an important factor for the improvement of patient's quality of life. The aim of this study is to report pain control results and functional outcome scores associated with adductor canal blockade (ACB) usage post-TKA. Methods: A prospective case series study of patients who underwent TKA for degenerative osteoarthritis with ACB postoperatively from 2018 to 2019 in a single center in Saudi Arabia, Riyadh. Assessment of functional outcome scores and pain level were measured preoperatively and postoperatively respectively using Knee injury and Osteoarthritis Outcome Score (KOOS) and the Visual Analog Scale (VAS). Results: Average KOOS score preoperatively for all 5 domains showed a marked improvement at 3 months compared to preoperative values. Pain score postoperatively was measured at 12, 24, and 48 h with an average of 0.7, 1.2, and 0.6 out of 10 on the VAS scale, respectively. The incidence of associated common side effects with the use of analgesic use was included as an add-on in the postoperative questionnaire. Conclusion: In conclusion, by comparing preoperative and postoperative pain levels and functional outcome scores, our study showed a significant pain control and improved functional outcome scores following TKA using ACB.

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“…Patient satisfaction level was associated, among other factors, with less pain and improved functional status, while dissatisfaction was associated with a longer hospital stay [ 3 ]. An important component of healing following TKA is postoperative pain and its management that accelerates recovery and improves patient satisfaction [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The Use of Opioids and Pain Medications in the Management of Postoperative Pain in Total Knee Arthroplasty Patients: A Retrospective Study

Almustafa

Der-Boghossian

Taha

2022

Pain Research and Management

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Purpose. The opioid crisis amplified the concern for the appropriate use of opioids. Our study aims to investigate the pain levels and amount of opiates needed during the first three days following total knee arthroplasty (TKA), whereby Drug Enforcement Administration (DEA) Schedule II oral opiates are not available. Methods. A year-long retrospective review of adult patients who underwent TKA was conducted. The postoperative pain scores and mean morphine equivalents (MME) were measured. These outcomes were assessed according to demographics, anesthesia, and analgesia used. Results. For our 78 patients, there was no statistical difference for stratification by baseline characteristics except in spinal anesthesia, which decreased pain on the first day. Conversely, MME increased to its significantly highest of 14.22 ± 29.58 mg on day 3. The effect was noted for patient-controlled analgesia where patients with intravenous analgesia received less opioid than those on epidural analgesia on postoperative day one. Conclusions. Using a similar regimen of analgesia, postoperative pain following TKA would be controlled by a relatively low amount of opioids by the third postoperative day. Spinal anesthesia and patient-controlled epidural analgesia were linked to better pain control and less opioid needed.

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Pain Management and Anesthesia in Total Knee Arthroplasty

Cited by 4 publications

References 13 publications

Multimodal Pain Management for Major Joint Replacement Surgery

Multimodal Pain Management for Major Joint Replacement Surgery

Adductor canal catheter block after total knee arthroplasty in patients with severe osteoarthritis and limited mobility. A single center study in Riyadh, Saudi Arabia

The Use of Opioids and Pain Medications in the Management of Postoperative Pain in Total Knee Arthroplasty Patients: A Retrospective Study

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