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Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques
OBJECTIVES: To evaluate three different analgesic techniques, continuous epidural analgesia (EA), continuous intra-articular (IA) infusion analgesia and continuous femoral nerve block (FNB) in postoperative pain management, length of hospital stay (LOS), and time of patient mobilization after total...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Society of Musculoskeletal and Neuronal Interactions
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020020/ https://www.ncbi.nlm.nih.gov/pubmed/33657760 |
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author | Karpetas, Georgios Z. Spyraki, Maria K. Giakoumakis, Savvas I. Fligou, Fotini G. Megas, Panagiotis D. Voyagis, Gregorios S. Panagiotopoulos, Elias C. |
author_facet | Karpetas, Georgios Z. Spyraki, Maria K. Giakoumakis, Savvas I. Fligou, Fotini G. Megas, Panagiotis D. Voyagis, Gregorios S. Panagiotopoulos, Elias C. |
author_sort | Karpetas, Georgios Z. |
collection | PubMed |
description | OBJECTIVES: To evaluate three different analgesic techniques, continuous epidural analgesia (EA), continuous intra-articular (IA) infusion analgesia and continuous femoral nerve block (FNB) in postoperative pain management, length of hospital stay (LOS), and time of patient mobilization after total knee arthroplasty (TKA). METHODS: Seventy-two patients undergoing TKA were randomly allocated into three groups according to the analgesic technique used for postoperative pain management. Group EA patients received epidural analgesia (control group), group IA received intra-articular infusion and group FNB received femoral nerve block. RESULTS: Upon analyzing the Numerical Rating Scale (NRS) scores at rest, at passive and active movement, up to 3 days postoperatively, we observed no statistically significant differences at any time point among the three groups. Similarly, no association among these analgesic techniques (EA, IA, FNB) was revealed regarding LOS. However, significant differences emerged concerning the time of mobilization. Patients who received IA achieved earlier mobilization compared to FNB and EA. CONCLUSIONS: Both IA and FNB generate similar analgesic effect with EA for postoperative pain management after TKA. However, IA appears to be significantly more effective in early mobilization compared to EA and FNB. Finally, no clinically important differences could be detected regarding LOS among the techniques studied. |
format | Online Article Text |
id | pubmed-8020020 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | International Society of Musculoskeletal and Neuronal Interactions |
record_format | MEDLINE/PubMed |
spelling | pubmed-80200202021-04-08 Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques Karpetas, Georgios Z. Spyraki, Maria K. Giakoumakis, Savvas I. Fligou, Fotini G. Megas, Panagiotis D. Voyagis, Gregorios S. Panagiotopoulos, Elias C. J Musculoskelet Neuronal Interact Original Article OBJECTIVES: To evaluate three different analgesic techniques, continuous epidural analgesia (EA), continuous intra-articular (IA) infusion analgesia and continuous femoral nerve block (FNB) in postoperative pain management, length of hospital stay (LOS), and time of patient mobilization after total knee arthroplasty (TKA). METHODS: Seventy-two patients undergoing TKA were randomly allocated into three groups according to the analgesic technique used for postoperative pain management. Group EA patients received epidural analgesia (control group), group IA received intra-articular infusion and group FNB received femoral nerve block. RESULTS: Upon analyzing the Numerical Rating Scale (NRS) scores at rest, at passive and active movement, up to 3 days postoperatively, we observed no statistically significant differences at any time point among the three groups. Similarly, no association among these analgesic techniques (EA, IA, FNB) was revealed regarding LOS. However, significant differences emerged concerning the time of mobilization. Patients who received IA achieved earlier mobilization compared to FNB and EA. CONCLUSIONS: Both IA and FNB generate similar analgesic effect with EA for postoperative pain management after TKA. However, IA appears to be significantly more effective in early mobilization compared to EA and FNB. Finally, no clinically important differences could be detected regarding LOS among the techniques studied. International Society of Musculoskeletal and Neuronal Interactions 2021 /pmc/articles/PMC8020020/ /pubmed/33657760 Text en Copyright: © Journal of Musculoskeletal and Neuronal Interactions http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Karpetas, Georgios Z. Spyraki, Maria K. Giakoumakis, Savvas I. Fligou, Fotini G. Megas, Panagiotis D. Voyagis, Gregorios S. Panagiotopoulos, Elias C. Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques |
title | Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques |
title_full | Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques |
title_fullStr | Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques |
title_full_unstemmed | Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques |
title_short | Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques |
title_sort | multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020020/ https://www.ncbi.nlm.nih.gov/pubmed/33657760 |
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