Abstract
Total knee arthroplasty is often associated with acute pain after surgery, which frequently develops into chronic pain. Careful management of pain during and after surgery, including implementation of a multimodal analgesic strategy, may lead to less pain after surgery, faster functional recovery and a lower likelihood of chronic post-surgical pain.
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Puolakka PA, Rorarius MG, Roviola M, et al. Persistent pain following knee arthroplasty. Eur J Anaesthesiol. 2010;27(5):455–60.
Beswick AD, Wylde V, Gooberman-Hill R, et al. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012;2(1):e000435.
McCartney CJ, Nelligan K. Postoperative pain management after total knee arthroplasty in elderly patients: treatment options. Drugs Aging. 2014;31(2):83–91.
Kehlet H, Dahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg. 1993;77(5):1048–56.
Buvanendran A, Kroin JS, Tuman KJ, et al. Effects of perioperative administration of a selective cyclooxygenase 2 inhibitor on pain management and recovery of function after knee replacement: a randomized controlled trial. JAMA. 2003;290(18):2411–8.
Huang YM, Wang CM, Wang CT, et al. Perioperative celecoxib administration for pain management after total knee arthroplasty: a randomized, controlled study. BMC Musculoskel Disord. 2008;9:77.
Zhu Y, Wang S, Wu H, et al. Effect of perioperative parecoxib on postoperative pain and local inflammation factors PGE2 and IL-6 for total knee arthroplasty: a randomized, double-blind, placebo-controlled study. Eur J Orthop Surg Traumatol. 2014;24(3):395–401.
Reuben SS, Buvenandran A, Katz B, et al. A prospective randomized trial on the role of perioperative celecoxib administration for total knee arthroplasty: improving clinical outcomes. Anesth Analg. 2008;106(4):1258–64.
Memtsoudis SG, Sun X, Chiu YL, et al. Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. Anesthesiology. 2013;118(5):1046–58.
Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ. 2000;321(7275):1493.
Capdevila X, Barthelet Y, Biboulet P, et al. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology. 1999;91(1):8–15.
Fischer HB, Simanski CJ, Sharp C, et al. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty. Anaesthesia. 2008;63(10):1105–23.
Frassanito L, Vergari A, Zanghi F, et al. Post-operative analgesia following total knee arthroplasty: comparison of low-dose intrathecal morphine and single-shot ultrasound-guided femoral nerve block: a randomized, single blinded, controlled study. Eur Rev Med Pharmacol Sci. 2010;14(7):589–96.
Sites BD, Beach M, Gallagher JD, et al. A single injection ultrasound-assisted femoral nerve block provides side effect-sparing analgesia when compared with intrathecal morphine in patients undergoing total knee arthroplasty. Anesth Analg. 2004;99(5):1539–43.
Liu SS, Strodtbeck WM, Richman JM, et al. A comparison of regional versus general anesthesia for ambulatory anesthesia: a meta-analysis of randomized controlled trials. Anesth Analg. 2005;101(6):1634–42.
Salinas FV, Liu SS, Mulroy MF. The effect of single-injection femoral nerve block versus continuous femoral nerve block after total knee arthroplasty on hospital length of stay and long-term functional recovery within an established clinical pathway. Anesth Analg. 2006;102(4):1234–9.
Bingham AE, Fu R, Horn JL, et al. Continuous peripheral nerve block compared with single-injection peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials. Reg Anesth Pain Med. 2012;37(6):583–94.
Paul JE, Arya A, Hurlburt L, et al. Femoral nerve block improves analgesia outcomes after total knee arthroplasty: a meta-analysis of randomized controlled trials. Anesthesiology. 2010;113(5):1144–62.
Ilfeld BM, Hadzic A. Walking the tightrope after knee surgery: optimizing postoperative analgesia while minimizing quadriceps weakness. Anesthesiology. 2013;118(2):248–50.
Scott NB. Wound infiltration for surgery. Anaesthesia. 2010;65(Suppl 1):67–75.
Kehlet H, Andersen LO. Local infiltration analgesia in joint replacement: the evidence and recommendations for clinical practice. Acta Anaesthesiol Scand. 2011;55(7):778–84.
McCartney CJ, Sinha A, Katz J. A qualitative systematic review of the role of N-methyl-d-aspartate receptor antagonists in preventive analgesia. Anesth Analg. 2004;98(5):1385–400.
Adam F, Chauvin M, Du Manoir B, et al. Small-dose ketamine infusion improves postoperative analgesia and rehabilitation after total knee arthroplasty. Anesth Analg. 2005;100(2):475–80.
Bremner S, Webster F, Katz J, et al. Older adults’ postoperative pain medication usage after total knee arthroplasty: a qualitative descriptive study. J Opioid Manag. 2012;8(3):145–52.
Moore RA. What works for whom? Determining the efficacy and harm of treatments for pain. Pain. 2013;154:S77–86.
Carmichael NM, Katz J, Clarke H, et al. An intensive perioperative regimen of pregabalin and celecoxib reduces pain and improves physical function scores six weeks after total hip arthroplasty: a prospective randomized controlled trial. Pain Res Manag. 2013;18(3):127–32.
Schroer WC, Diesfeld PJ, LeMarr AR, et al. Benefits of prolonged postoperative cyclooxygenase-2 inhibitor administration on total knee arthroplasty recovery: a double-blind, placebo-controlled study. J Arthroplasty. 2011;26(6 Suppl):2–7.
Buvanendran A, Kroin JS, Della Valle CJ, et al. Perioperative oral pregabalin reduces chronic pain after total knee arthroplasty: a prospective, randomized, controlled trial. Anesth Analg. 2010;110(1):199–207.
Disclosure
This article was adapted from Drugs & Aging 2014;31:2:83–91 [3]. The preparation of these articles was not supported by any external funding.
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Adis Medical Writers. Manage pain before, during and after total knee arthroplasty using a multimodal approach to analgesia. Drugs Ther Perspect 30, 321–324 (2014). https://doi.org/10.1007/s40267-014-0138-0
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DOI: https://doi.org/10.1007/s40267-014-0138-0