Perioperative Pain Management for Orthopedic and Spine Surgery

Pushparaj, Hemkumar; Bhatia, Anuj

doi:10.1213/ane.0000000000004308

Cited by 2 publications

(3 citation statements)

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“…(1) Cognitive intervention: cognitive intervention is an effective measure to improve the quality of pain management and occupies an important position in the perioperative nursing of orthopedic surgery [ 8 ]. Preoperatively, medical staff should provide patients with a general understanding of the surgical procedure and timely communication with the patient, so that the patient can change the initial cognition of perioperative pain as well as correct cognition of the operation.…”

Section: Methodsmentioning

confidence: 99%

Application of a Knowledge, Attitude, Belief, and Practice Model in Pain Management of Patients with Acute Traumatic Fractures and Alcohol Dependence

Duan

Gao

Jin

et al. 2022

Pain Research and Management

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Objective. To evaluate the outcome of a knowledge, attitude, belief, and practice mode (KABP) in the pain management in patients with acute traumatic fractures complicated with alcohol dependence. Methods. Twenty-nine alcohol-dependent male patients with acute traumatic fractures and who received surgical treatment between January 2019 and December 2020 were included in this retrospective case-control study. The age range was 30–65 years (average 50.03 ± 7.94). Fracture Type. Six cases of spinal burst fractures and 23 cases of limb trauma fractures. Ten patients were treated with routine nursing (control group), and 19 patients were treated with pain management in KABP mode (experimental group). The control group received traditional pain care, including the conventional numerical rating scale (NRS) pain score system, with focus on symptomatic treatment. On this basis, the experimental group managed pain using KABP, including cognitive behavioral intervention, optimization programs, modification of personal beliefs, and behavior patterns. NRS, self-rated anxiety/depression scale (SAS), and quality of life (SF-36) scale were applied at admission, 1 day before surgery, and 3 months after surgery. Results. The perioperative NRS score of the KABP group was lower than that of the control group, and the postoperative anxiety levels improved. Discharge satisfaction was significantly higher than that in the control group ( p < 0.05 ). There were behaviors promoting health in the experimental group, and five patients expressed abstinence behavior after discharge ( p < 0.05 ). Conclusion. Patients with alcohol dependence represents a unique set of cases for perioperative pain management. To ensure patient safety, individualized pain management through the application of KABP can significantly reduce postoperative pain and promote the generation of healthy behaviors in patients.

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Section: Methodsmentioning

confidence: 99%

Application of a Knowledge, Attitude, Belief, and Practice Model in Pain Management of Patients with Acute Traumatic Fractures and Alcohol Dependence

Duan

Gao

Jin

et al. 2022

Pain Research and Management

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“…Following orthopedic surgical procedures where severe pain can be experienced by the patient before the surgery and afterward, detailed preoperative analgesia is crucial to enhancing patient recovery, pain ratings, and rehabilitation [25,26].…”

Section: Multimodal Analgesia Protocolmentioning

confidence: 99%

“…Ketamine, which antagonizes an NMDA receptor, has been proven to decrease opioid consumption via receptor modulation and lowering central excitability also function in conjunction with acetaminophen and nonsteroidal anti-inflammatory drugs intraoperatively. Throughout the surgical procedure, acetaminophen, dexamethasone, ondansetron, and famotidine are given [25,30]. Further, intraoperative use of bupivacaine was administered in a one-time dose typically towards the conclusion of surgery to provide significant incremental pain relief.…”

Section: Intraoperative Componentmentioning

confidence: 99%

Lateral Lumbar Interbody Fusion in the Outpatient Setting with Multimodal Analgesic Protocol: Clinical Case Series

Jacob

Patel

Pawlowski

et al. 2022

J Minim Invasive Spine Surg Tech

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Objective: Minimally invasive techniques and multimodal analgesia protocols have made spine surgery in the outpatient setting increasingly feasible. A number of spinal procedures have been documented in the outpatient setting, though the feasibility of lateral lumbar interbody fusion (LLIF) on an ambulatory basis has not been thoroughly assessed. To present a clinical case series of patients undergoing LLIF in the outpatient setting.Methods: A prospectively maintained surgical database was retrospectively reviewed to identify patients undergoing outpatient spine procedures with an enhanced multimodal analgesia protocol from October 2016 to February 2021. Patient demographics, medical and spinal diagnoses, procedural characteristics, operative duration, estimated blood loss (EBL), postoperative length of stay (LOS), postoperative pain scores, postoperative narcotic consumption, and incidence of any intra- or postoperative complications were collected. The state’s prescription monitoring program was queried to assess rates of filling narcotic prescriptions >6 weeks following surgery.Results: A total of 24 LLIF patients were included. Mean postoperative pain score was 5.8, and mean postoperative narcotic consumption was 26.8 oral morphine equivalents. All patients were discharged on the same day of surgery. No postoperative complications were observed. After the 6-week postoperative timepoint, 16.7% of patients filled a prescription for tramadol, 8.3% for hydrocodone, 4.2% for hydromorphone, 4.2% for cyclobenzaprine, and 4.2% for alprazolam. Conclusion: This clinical case series demonstrates that LLIF can be both safe and feasible in the outpatient setting, with minimal narcotic medication dependence in the postoperative period.

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Perioperative Pain Management for Orthopedic and Spine Surgery

Cited by 2 publications

References 0 publications

Application of a Knowledge, Attitude, Belief, and Practice Model in Pain Management of Patients with Acute Traumatic Fractures and Alcohol Dependence

Application of a Knowledge, Attitude, Belief, and Practice Model in Pain Management of Patients with Acute Traumatic Fractures and Alcohol Dependence

Lateral Lumbar Interbody Fusion in the Outpatient Setting with Multimodal Analgesic Protocol: Clinical Case Series

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