Novel multimodal analgesia protocol following whole knee arthroplasty affords ache reduction with out opioids

A learn about led by way of Vinod Dasa, MD, Professor of Orthopaedics at LSU Well being New Orleans Faculty of Medication, experiences {that a} novel surgical ache control technique following whole knee arthroplasty (TKA), or whole knee alternative, equipped ache reduction with out opioids. The researchers additionally discovered that converting prescriptions for opioids at discharge from computerized to upon request dramatically lowered opioid use. Their effects are printed within the Magazine of Experimental Orthopaedics.

About 70% of opioid-naïve sufferers wanted most effective Tylenol and anti inflammatory drugs to control their ache. Opioid use in well being care is making improvements to however stays tough to control. Surgical ache used to be lengthy regarded as unavoidable, requiring a considerable amount of ache drugs. Growing leading edge methods to beef up surgical restoration by way of lowering ache and getting rid of opioids can lend a hand clear up a few of our largest demanding situations.”

Dr. Vinod Dasa, MD, Professor of Orthopaedics, LSU Well being New Orleans Faculty of Medication

The 144 sufferers within the retrospective learn about gained the similar multimodal analgesia protocol excluding for postoperative opioid prescribing. The unconventional multimodal analgesia routine incorporated percutaneous cryo-neurolysis, a long-acting nerve block, about 5 days earlier than surgical treatment. Instantly earlier than surgical treatment, sufferers gained a unmarried dose of 150 mg pregabalin, 200 mg celecoxib, and 1000 mg intravenous (IV) acetaminophen. Upon discharge, all sufferers have been recommended to take 325 mg of acetaminophen each 4 hours for 2 weeks and 75 mg of diclofenac each 12 hours for six weeks.

The authors conclude, “Greater than part of all TKA sufferers and 72% of opioid-naïve sufferers who have been handled with a multimodal ache protocol designed to reduce opioid use for as much as 3 months, and gained opioids most effective upon request after surgical treatment, recovered from TKA with out the usage of any opioids and any worsening of self-reported ache or knee-related issues when put next with sufferers who gained an opioid prescription mechanically upon discharge.”

The authors additionally incorporated Drs. Amy Bronstone and Peter Yager at LSU Well being New Orleans Faculty of Medication’s Division of Orthopaedics, Dr. Claudia Leonardi, Assistant Professor of Behavioral and Neighborhood Well being Sciences at LSU Well being New Orleans Faculty of Public Well being and LSU Well being New Orleans clinical scholars Leland van Deventer and Matthew Bennett.


Magazine reference:

van Deventer, L., et al. (2023) A contemporary multimodal ache protocol gets rid of the desire for opioids for many sufferers following whole knee arthroplasty: effects from a retrospective comparative cohort learn about. Magazine of Experimental Orthopaedics.

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