Postoperative Pain Management in Total Knee Arthroplasty.

Autor: Li JW; Department of Orthopaedic Surgery, Yueyang Second People's Hospital, Yueyang, China.; Department of Orthopaedic Surgery, Yueyang Hospital Affiliated to Hunan Normal University, Yueyang, China., Ma YS; Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, China., Xiao LK; Department of Orthopaedic Surgery, Yueyang Second People's Hospital, Yueyang, China.; Department of Orthopaedic Surgery, Yueyang Hospital Affiliated to Hunan Normal University, Yueyang, China.
Jazyk: angličtina
Zdroj: Orthopaedic surgery [Orthop Surg] 2019 Oct; Vol. 11 (5), pp. 755-761.
DOI: 10.1111/os.12535
Abstrakt: Total knee arthroplasty (TKA) is one of the most common surgeries performed to relieve joint pain in patients with end-stage osteoarthritis or rheumatic arthritis of the knee. However, TKA is followed by moderate to severe postoperative pain that affects postoperative rehabilitation, patient satisfaction, and overall outcomes. Historically, opioids have been widely used for perioperative pain management of TKA. However, opioids are associated with undesirable adverse effects, such as nausea, respiratory depression, and retention of urine, which limit their application in daily clinical practice. The aim of this review was to discuss the current postoperative pain management regimens for TKA. Our review of the literature demonstrated that multimodal analgesia is considered the optimal regimen for perioperative pain management of TKA and improves clinical outcomes and patient satisfaction, through a combination of several types of medications and delivery routes, including preemptive analgesia, neuraxial anesthesia, peripheral nerve blockade, patient-controlled analgesia and local infiltration analgesia, and oral opioid/nonopioid medications. Multimodal analgesia provides superior pain relief, promotes recovery of the knee, and reduces opioid consumption and related adverse effects in patients undergoing TKA.
(© 2019 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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