Skip to main content

Perioperative Pain Management and Orthopedic Surgery

  • Chapter
  • First Online:
Perioperative Management of Patients with Rheumatic Disease
  • 1542 Accesses

Abstract

Given the nature of orthopedic surgery, moderate to severe pain should be anticipated with almost every major procedure. To achieve a reasonable degree of patient satisfaction, a well-designed plan to control acute pain should be a part of every procedure. Ideally, the plan should be presented to patients before they go to the operating room so that they will understand their role in the plan and can participate fully. This approach assures the patient that some intervention to deal with acute pain will be implemented before excruciating pain is felt.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lutz LJ, Lamer TJ. Management of postoperative pain: review of current techniques and methods. Mayo Clin Proc. 1990;65:584–96.

    Article  CAS  PubMed  Google Scholar 

  2. Hebl JR, Dilger JA, Byer DE, Kopp SL, Stevens SR, Pagnano MW, Hanssen AD, Horlocker TT. A pre-emptive multimodal pathway featuring peripheral nerve block improves perioperative outcomes after major orthopedic surgery. Reg Anesth Pain Med. 2008;33:510–7.

    PubMed  Google Scholar 

  3. Duellman TJ, Gaffigan C, Milbrandt JC, Allan DG. Multi-modal, pre-emptive analgesia decreases the length of hospital stay following total joint arthroplasty. Orthopedics. 2009;32:1–5.

    Article  Google Scholar 

  4. Duncan CM, Long KH, Warner DO, Hebl JR. The economic implications of a multimodal analgesic regimen for patients undergoing major orthopedic surgery. Reg Anesth Pain Med. 2009;34:301–7.

    Article  PubMed  Google Scholar 

  5. LaMotte RH. Neurophysiological mechanisms of cutaneous secondary hyperalgesia in the primate. In: Willis WD, editor. Hyperalgesia and allodynia. New York: Raven Press; 1992. p. 175–85.

    Google Scholar 

  6. Schaible HG, Schmidt RF. Direct observation of sensitization of articular afferents during experi­mental arthritis. In: Proceedings of the Vth world congress on pain. Amsterdam: Elsevier; 1988. p. 44–50.

    Google Scholar 

  7. Kinnman E, Aldskogius H, Wiesenfeld-Hallin Z, Johansson O. Expansion of sensory innervation after peripheral nerve injury. In: Proceedings of the Vth world congress on pain. Elsevier; 1988. p. 277–82.

    Google Scholar 

  8. Wilcox GL. Excitatory neurotransmitters and pain. In: Proceedings of the Vth world congress on pain. Boston: Elsevier; 1988. p. 97–117.

    Google Scholar 

  9. Kendig JJ. Spinal cord as a site of anesthetic action. Anesthesiology. 1993;79:1161–2.

    CAS  PubMed  Google Scholar 

  10. Yamamoto T, Shimoyama N, Mizuguchi T. Role of the injury discharge in the development of thermal hyperesthesia after sciatic nerve constriction injury in the rat. Anesthesiology. 1993;79:993–1002.

    Article  CAS  PubMed  Google Scholar 

  11. Katz J, Kavanagh BP, Sandler AN, et al. Preemptive analgesia. Clinical evidence of neuroplasticity contributing to postoperative pain. Anesthesiology. 1992;77:439–46.

    Article  CAS  PubMed  Google Scholar 

  12. Woolf CJ, Chong MS. Preemptive analgesia- treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg. 1993;77:362–79.

    CAS  PubMed  Google Scholar 

  13. Malmberg AB, Yaksh TL. Pharmacology of the spinal action of ketorolac, morphine, ST-91, U50488H, and L-PIA on the formalin test and an isobolographic analysis of the NSAID interaction. Anesthesiology. 1993;79:270–81.

    Article  CAS  PubMed  Google Scholar 

  14. Munro HM, Walton SR, Malviya S, Merkel S, Voepel-Lewis T, Loder RT, Farley FA. Low-dose ketorolac improves analgesia and reduces morphine requirements following posterior spinal fusion in adolescents. Can J Anaesth. 2002;49:461–6.

    Article  PubMed  Google Scholar 

  15. Rosenow DE, Alberchtsen M, Stolke D. A comparison of patient-controlled analgesia with lornoxicam versus morphine in patients undergoing lumbar disc surgery. Anesth Analg. 1998;86:1045–50.

    CAS  PubMed  Google Scholar 

  16. Fenton C, Keating GM, Wagstaff AJ. Valdecoxib. A review of its use in the management of osteoarthritis, rheumatoid arthritis, dysmenorrhoea and acute pain. Drug. 2004;64:1231–61.

    Article  CAS  Google Scholar 

  17. Bannwarth B, Berenbaum F. Clinical pharmacology of lumiracoxib, a second-generation cyclooxygenase 2 selective inhibitor. Expert Opin Investig Drugs. 2005;14:521–33.

    Article  CAS  PubMed  Google Scholar 

  18. Weaver AL. Refecoxib: clinical pharmacology and clinical experience. Clin Ther. 2001;23:1323–38.

    Article  CAS  PubMed  Google Scholar 

  19. Capdevilla X, Pirat P, Bringuier S, Gaertner E, Singelyn F, Bernard N, Choquet O, Bouaziz H, Bonnet F. Continuous peripheral nerve blocks in hospital wards after orthopedic surgery. Anesthesio­logy. 2005;103:1035–45.

    Article  Google Scholar 

  20. Capdevilla X, Dadure C, Bringuier S, Bernard N, Biboulet P, Gaertner E, Macaire P. Effect of patient controlled perineural analgesia on rehabilitation and pain after ambulatory orthopedic surgery. Anesthesiology. 2006;105:566–73.

    Article  Google Scholar 

  21. Bagry H, de la Cuadra JC, Asenjo JF, Bracco D, Carli F. Effect of continuous peripheral nerve block on the inflammatory response in knee arthroplasty. Reg Anesth Pain Med. 2008;33:17–23.

    PubMed  Google Scholar 

  22. Martin F, Martinez V, Mazoit JX, Bouhassira D, Cherif K, Gentili E, Pirou P, Chauvin M, Fletcher D. Antiinflammatory effect of peripheral nerve blocks after knee surgery. Anesthesiology. 2008;109:484–90.

    Article  CAS  PubMed  Google Scholar 

  23. De Andres J, Bellver J, Barrera L, Febre E, Bolinches R. A comparative study of analgesia after knee surgery with intraarticular bupivacaine, intraarticular morphine and lumbar plexus block. Anesth Analg. 1994;77:727–30.

    Google Scholar 

  24. Stein C, Comisel K, Haimerl E, et al. Analgesic effects of intraarticular morphine after arthroscopic knee surgery. N Engl J Med. 1991;325:1123–6.

    Article  CAS  PubMed  Google Scholar 

  25. Tetzlaff JE, Dilger JA, Abate J, Parker RD. Preoperative intra-articular morphine and bupivacaine for pain control after outpatient arthroscopic anterior cruciate ligament reconstruction. Reg Anesth Pain Med. 1999;34:220–4.

    Google Scholar 

  26. Gomoli AH, Yanke AB, Kang RW, Chubinskaya S, Williams JM, Bach BR, Cole BJ. Lon-tern effects of bupivacaine on cartilage in a rabbit shoulder model. Am J Sports Med. 2009;37:72–7.

    Article  Google Scholar 

  27. Solomon RE, Gebhart GF. Synergistic antinociceptive interactions among drugs administered to the spinal cord. Anesth Analg. 1994;78:1164–72.

    Article  CAS  PubMed  Google Scholar 

  28. Wang C, Chakrabarti MK, Whitwam JG. Specific enhancement by fentanyl of the effects of intrathecal bupivacaine on nociceptive afferent but not on sympathetic efferent pathways in dogs. Anesthesiology. 1993;79:766–73.

    Article  CAS  PubMed  Google Scholar 

  29. Tverskoy M, Oz Y, Isakson A, Finger J, Bradley EL, Kissin I. Pre-emptive effect of fentanyl and ketamine on postoperative pain and wound hyperalgesia. Anesth Analg. 1994;78:205–9.

    Article  CAS  PubMed  Google Scholar 

  30. Sugiyama K, Muteki T. Local anesthetics depress the calcium current of rat sensory neurons in culture. Anesthesiology. 1994;80:1369–78.

    Article  CAS  PubMed  Google Scholar 

  31. Omote K, Sonoda H, Kawamata M, Iwasaki H, Namiki A. Potentiation of antinociceptive effects of morphine by calcium channel blockers at the level of the spinal cord. Anesthesiology. 1993;79:746–52.

    Article  CAS  PubMed  Google Scholar 

  32. McQuay HJ, Carroll D, Moore RA. Postoperative pain- the effect of opiate premedication and local anesthetic blocks. Pain. 1988;33:291–5.

    Article  CAS  PubMed  Google Scholar 

  33. Kiss IE, Kilian M. Does opiate premedication influence postoperative analgesia? A prospective study. Pain. 1992;48:157–8.

    Article  CAS  PubMed  Google Scholar 

  34. Taivainen T, Hiller A, Rosenberg PH, Neuvonen P. The effect of continuous indomethacin infusion on bleeding time and postoperative pain in patients undergoing emergency surgery of the lower extremities. Acta Anaesthesiol Scand. 1989;33:58–60.

    Article  CAS  PubMed  Google Scholar 

  35. Todd BD, Reed SC. The use of bupivacaine to relieve pain at iliac graft donor sites. Int Orthop. 1991;15:53–5.

    Article  CAS  PubMed  Google Scholar 

  36. Fredrickson MJ, Krishnan S, Chen CY. Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniques. Anaesthesia. 2010;65:547–8.

    Article  Google Scholar 

  37. Tuominen M, Haasio J, Hekali R, Rosenberg PH. Continuous interscalene brachial plexus block: clinical efficacy, technical problems and bupivacaine plasma concentrations. Acta Anaesthesiol Scand. 1989;33:84–8.

    Article  CAS  PubMed  Google Scholar 

  38. Haasio J, Tuominen M, Rosenberg PH. Continuous interscalene brachial plexus block during and after shoulder surgery. Ann Chir Gynaecol. 1990;79:103–7.

    CAS  PubMed  Google Scholar 

  39. Tuominen MK, Pere P, Rosenberg PH. Unintentional arterial catheterization and bupivacaine toxicity associated with continuous interscalene brachial plexus block. Anesthesiology. 1991;75:356–8.

    Article  CAS  PubMed  Google Scholar 

  40. Goebel S, Stehle J, Schwemmer U, Reppenhagen S, Rath B, Gohlke F. Interscalene brachial plexus block for open-shoulder surgery: a randomized, double-blind, placebo-controlled trial between single-shot and patient-controlled catheter system. Arch Orthop Trauma Surg. 2010;130:533–40.

    Article  PubMed  Google Scholar 

  41. Mariano ER, Llolan VJ, Ilfeld BM. Interscalene perineural catheter placement using an ultrasound-guided posterior approach. Reg Anesth Pain Med. 2009;34:60–3.

    Article  PubMed  Google Scholar 

  42. Fredrickson MJ, Ball CM, Dalgleish AJ, Stewart AW, Short TG. A prospective randomized comparison of ultrasound and neurostimulation as needle endpoint for interscalene catheter placement. Anesth Analg. 2009;108:1695–700.

    Article  PubMed  Google Scholar 

  43. Borgeat A, Schappi B, Biasca N, Gerber C. Patient-controlled analgesia after major shoulder surgery. Anesthesiology. 1997;87:1343–7.

    Article  CAS  PubMed  Google Scholar 

  44. Klein SM, Grant SA, Greengrass RA, et al. Interscalene brachial plexus block with a continuous catheter insertion system and a disposable pump. Anesth Analg. 2000;91:473–8.

    Google Scholar 

  45. Ilfeld BM, Morey TE, Wright TW, Chidgey LK, Enneking FK. Continuous interscalene brachial plexus block for postoperative pain control at home: a randomized, double-blinded, placebo-controlled study. Anesth Analg. 2003;96:1089–95.

    Article  PubMed  Google Scholar 

  46. Singelyn FJ, Seguy S, Gouveneur JM. Interscalene brachial plexus analgesia after open shoulder surgery: continuous versus patient-controlled infusion. Anesth Analg. 1999;89:1216–20.

    Article  CAS  PubMed  Google Scholar 

  47. Kirkpatrick AF, Bednarczyklr LR, Hime GW, et al. Bupivacaine blood levels during continuous interscalene block. Anesthesiology. 1985;62:65–7.

    Article  CAS  PubMed  Google Scholar 

  48. Boezaart AP, de Beer JF, du Toit C, van Rooyen K. A new technique of continuous interscalene nerve block. Can J Anaesth. 1999;46:275–81.

    Article  CAS  PubMed  Google Scholar 

  49. Borgeat A, Perschak H, bird P, Hodler J, Gerber C. Patient-controlled interscalene analgesia with ropivacaine 0.2% versus patient-controlled intravenous analgesia after major shoulder surgery. Anesthesio­logy. 2000;92:102–8.

    Article  CAS  PubMed  Google Scholar 

  50. Pere P. The effect of continuous interscalene brachial plexus block with 0.125% bupivacaine plus fentanyl on diaphragmatic motility and ventilatory function. Reg Anesth. 1993;18:93–7.

    CAS  PubMed  Google Scholar 

  51. Haasio J, Tuominen M, Rosenberg PH. Continuous interscalene plexus block during and after shoulder surgery. Ann Surg Gynecol. 1990;79:103–7.

    CAS  Google Scholar 

  52. Coleman MM, Chan VWS. Continuous interscalene brachial plexus block. Can J Anaesth. 1999;46:209–14.

    Article  CAS  PubMed  Google Scholar 

  53. Reuben SS, Steinberg RB. Continuous shoulder analgesia via an indwelling axillary brachial plexus catheter. J Clin Anesth. 2000;12:472–5.

    Article  CAS  PubMed  Google Scholar 

  54. Fontana C, DiDonato A, DiGiacomjo G, Constanti A, DeVita A, Lancia F, Caricati A. Postoperative analgesia for arthroscopic shoulder surgery: a prospective randomized controlled study of intraarticular, subacromial injection, interscalene brachial plexus block, and intraarticular plus subacromial injection efficacy. Eur J Anaesthesiol. 2009;26:689–93.

    Article  PubMed  Google Scholar 

  55. Axelsson K, Gupta A, Johanzon E, Berg E, Ekback G, Rawal N, Enstrom P, Nordensson U. Intraarticular injection of ketorolac, morphine and ropivacaine, combined with intraarticular patient-controlled analgesia for pain relief after shoulder surgery: a rando­mized, double-blind study. Anesth Analg. 2008;106:328–33.

    Article  CAS  PubMed  Google Scholar 

  56. Busfield BT, Lee GH, Carillo M, Ortega R, Kharrazi FD. Subacromial pain pump use with arthroscopic shoulder surgery: a short-term prospective study of complications in 583 patients. J Shoulder Elbow Surg. 2008;17:860–2.

    Article  PubMed  Google Scholar 

  57. Ciccone WJ, Busey TD, Weinstein DM, Walden DL, Elias JJ. Assessment of pain provided by interscalene regional block and infusion pump after arthroscopic shoulder surgery. Arthroscopy. 2008;24:14–9.

    Article  PubMed  Google Scholar 

  58. Beaudet V, Willaims SR, Tetreault P, Perrault MA. Perioperative interscalene block versus intra-articular injection of local anesthetics for postoperative analgesia in shoulder surgery. Reg Anesth Pain Med. 2008;33:134–8.

    CAS  PubMed  Google Scholar 

  59. Coghlan JA, Forbes A, McKenzie D, Bell SN, Buchbinder R. Efficacy of subacromial ropivacaine infusion for rotator cuff surgery. A randomized trial. J Bone Joint Surg. 2009;91:1558–67.

    Article  PubMed  Google Scholar 

  60. Yamashita K, Fukasaki M, Ando Y, Tanabe T, Terao Y, Sumikawa K. Postoperative analgesia with minidose intrathecal morphine for bipolar hip prosthesis in extremely elderly patients. J Anesth. 2009;23:504–7.

    Article  PubMed  Google Scholar 

  61. Ben-David B, Lee E, Croitori M. Psoas block for surgical repair of hip fracture: a case report and description of a catheter technique. Anesth Analg. 1990;71:298–301.

    CAS  PubMed  Google Scholar 

  62. Chudinov A, Berkenstadt H, Salai M, Cahana A, Perel A. Continuous psoas compartment block for anesthesia and perioperative analgesia in patients with hip fractures. Reg Anesth Pain Med. 1999;24:563–8.

    CAS  PubMed  Google Scholar 

  63. Foss NB, Kristensen BB, Bundgaard M, Bak M, Heiring C, Virkelyst C, Hougaard S, Kehlet H. Fascia iliaca compartment blockade for acute pain control in hip fracture patients. Anesthesiology. 2007;106:773–8.

    Article  CAS  PubMed  Google Scholar 

  64. Hood G, Edbrooke DL, Gerrish SP. Postoperative analgesia after triple nerve block for fracture of the femur. Anaesthesia. 1991;46:138–40.

    Article  CAS  PubMed  Google Scholar 

  65. Coad NR. Post-operative analgesia following femoral-neck surgery- a comparison between 3 in 1 femoral nerve block and lateral cutaneous nerve block. Eur J Anesthesiol. 1991;8:287–90.

    CAS  Google Scholar 

  66. Milligan KR, Macafee AL, Fogarty DJ, Wallace RGH, Ramsey P. Intraoperative bupivacaine diminishes pain after lumbar diskectomy. J Bone Joint Surg (British). 1993;75B:769–71.

    Google Scholar 

  67. Otto S, Dietz C, Kuleszynski P, Hopf CH, Stanton-Hicks M, Dick W. Postoperative Analgesie bei spondylodesen mittels intraoperative gelegtem periduralka-theter. Anaesthesist. 1991;40:235–7.

    CAS  PubMed  Google Scholar 

  68. Cata JP, Noguera EM, Parke E, Ebrahim Z, Kurz A, Kalfas I, Masha E, Farag E. Patient controlled epidural analgesia (PCEA) for postoperative pain control after lumbar spine surgery. J Neurosurg Anesthesiol. 2008;20:256–60.

    Article  PubMed  Google Scholar 

  69. Joshi GP, McCarroll SM, O’Rourke K. Postoperative analgesia after lumbar laminectomy: epidural fentanyl infusion versus patient-controlled intravenous morphine. Anesth Analg. 1995;80:511–4.

    CAS  PubMed  Google Scholar 

  70. Bourke DL, Spatz E, Motara R, Ordia JI, Reed J, Hlavacek JM. Epidural opioids during laminectomy surgery for postoperative pain. J Clin Anesth. 1992;4:277–81.

    Article  CAS  PubMed  Google Scholar 

  71. Waikakul W, Chumniprasas K. Direct epidural morphine during lumbar diskectomy for postoperative analgesia. J Med Assoc Thai. 1992;75:428–33.

    CAS  PubMed  Google Scholar 

  72. Ross DA, Drasner K, Weinstein PR, Flaherty JF, Barbaro NM. Use of intrathecally administered morphine in the treatment of postoperative pain after lumbar spinal surgery: a prospective, double-blind, placebo-controlled study. Neurosurgery. 1991;28:700–4.

    Article  CAS  PubMed  Google Scholar 

  73. Ziegeler S, Feritsch E, Baurer C, Mencke T, Muller BL, Soltesz S, Silomon M. Therapeutic effect of intrathecal morphine after posterior interbody fusion surgery: a prospective, double-blind, randomized study. Spine. 2008;33:2379–86.

    Article  PubMed  Google Scholar 

  74. Bernard JM, Hommeril JL, Legendre MP, Passuti N, Pinaud M. Spinal or systemic analgesia after extensive spinal surgery: comparison between intrathecal morphine and intravenous fentanyl plus clonidine. J Clin Anesth. 1993;5:231–6.

    Article  CAS  PubMed  Google Scholar 

  75. McGlew IC, Angliss DB, Gee GJ, Rutherford A, Wood ATA. A comparison of rectal indomethacin with placebo for pain relief following spinal surgery. Anaesth Intensive Care. 1991;19:40–5.

    CAS  PubMed  Google Scholar 

  76. Nissen I, Jensen KA, Ohrstrom JK. Indomethacin in the management of postoperative pain. Br J Anaesth. 1992;69:304–6.

    Article  CAS  PubMed  Google Scholar 

  77. Coli A, Lari S, Vigano E, Perin S, Lari F. Valutazione dell’efficacia dei FANS nella prevenzione del dolore postoperatorio. Minerva Anestesiol. 1993;59:531–5.

    CAS  PubMed  Google Scholar 

  78. Jirattanaphocal K, Jung S. Nonsteroidal antiin-flammatory drugs for postoperative pain management after lumbar spine surgery: a meta-analysis of randomized controlled trials. J Neurosurg Spine. 2008;9:22–31.

    Article  Google Scholar 

  79. Lavyne MH, Bilsky MH. Epidural steroids, postoperative morbidity and recovery in patients undergoing microsurgical lumbar diskectomy. J Neurosurg. 1992;77:90–5.

    Article  CAS  PubMed  Google Scholar 

  80. Weller R, Rosenblum M, Conard P, Gross JB. Comparison of epidural and patient-controlled intravenous morphine following joint replacement surgery. Can J Anaesth. 1991;38:582–6.

    Article  CAS  PubMed  Google Scholar 

  81. McQueen DA, Kelley HK, Wright TF. A comparison of epidural and non-epidural anesthesia and analgesia in total hip and total knee arthroplasty patients. Orthopedics. 1992;15:169–73.

    CAS  PubMed  Google Scholar 

  82. Modig J, Paalzow L. A comparison of epidural morphine and epidural bupivacaine for postoperative pain relief. Acta Anaesth Scand. 1981;25:437–41.

    Article  CAS  PubMed  Google Scholar 

  83. Badner NH, Reimer EJ, Komar WE, Moote CA. Low-dose bupivacaine does not improve postoperative epidural fentanyl analgesia in orthopedic patients. Anesth Analg. 1991;72:337–41.

    Article  CAS  PubMed  Google Scholar 

  84. Martin G, Hamrtmannsgruber M, Riley E, Manvelian G. Single-dose extended-release epidural morphine for pain after hip arthroplasty. J Opioid Manag. 2006;2:209–18.

    PubMed  Google Scholar 

  85. Schaer H, Baasch K, Prochacka K. Intrathekales morphin fur postoperativen schmerz. Anaesthetist. 1992;41:689–93.

    CAS  Google Scholar 

  86. Drakeford MK, Pettine KA, Brookshire L, Ebert F. Spinal narcotics for postoperative analgesia in total joint arthroplasty. J Bone Joint Surg. 1991;73A:424–8.

    Google Scholar 

  87. Niemi L, Pitkanen MT, Tuominen MK, Rosenberg PH. Comparison of intrathecal fentanyl infusion with intrathecal morphine infusion or bolus for postoperative pain relief after total hip arthroplasty. Anesth Analg. 1993;77:126–30.

    Article  CAS  PubMed  Google Scholar 

  88. Milligan KR, Fogarty DJ. The characteristics of analgesic requirements following subarachnoid diamorphine in patients undergoing total hip replacement. Reg Anesth. 1993;18:114–7.

    CAS  PubMed  Google Scholar 

  89. Serpell MG, Millar FA, Thompson MF. Comparison of lumbar plexus block versus conventional opioid analgesia after total knee replacement. Anaesthesia. 1991;46:275–7.

    Article  CAS  PubMed  Google Scholar 

  90. Hirst GC, Scott SA, Dust WN, Cassidy JD, Yip RW. Femoral nerve block; single injection versus continuous infusion for total knee arthroplasty. Reg Anesth. 1996;21:292–7.

    CAS  PubMed  Google Scholar 

  91. Edwards ND, Wright EM. Continuous low-dose 3-in-1 nerve blockade for postoperative pain relief after total knee replacement. Anesth Analg. 1992;75:265–7.

    Article  CAS  PubMed  Google Scholar 

  92. Singelyn FJ, Gouverneur JA. Postoperative analgesia after total hip arthroplasty: IV PCA with morphine, patient-controlled epidural analgesia or continuous “3-in-1” block. J Clin Anesth. 1999;11:550–4.

    Article  CAS  PubMed  Google Scholar 

  93. Singelyn FJ, Gouverneur JA. Extended “three-in one” block after total knee arthroplasty: continuous versus patient-controlled technique. Anesth Analg. 2000;91:176–80.

    CAS  PubMed  Google Scholar 

  94. Uhrbrand B, Toftgaard Jensen T, Klitgaard Bendixen D, Flemming Hartmann-Andersen J. Perioperative analgesia by 3-in-one block in total hip arthroplasty prospective randomized blind study. Acta Orthop Belg. 1992;58:417–9.

    CAS  PubMed  Google Scholar 

  95. Striebel HW, Wilker E. Postoperative schmerztherapie nach totalendoprothetischen operationen an der hufte mittels kontinuierlicher 3-in-1 blockade. Anasthesiol Intensivmed Notfallmed Schmerzther. 1993;28:168–73.

    Article  CAS  PubMed  Google Scholar 

  96. Serpell MG, Thomson MF. Comparison of piroxicam with placebo in the management of pain after total hip replacement. Br J Anaesth. 1989;63:354–6.

    Article  CAS  PubMed  Google Scholar 

  97. Laitinen J, Nuutinen L. Intravenous diclofenac coupled with PCA fentanyl for pain relief after total hip replacement. Anesthesiology. 1992;76:194–8.

    Article  CAS  PubMed  Google Scholar 

  98. Claeys MA, Camu F, Maes V. Prophylactic diclofenac infusions in major orthopedic surgery: effects on analgesia and acute phase proteins. Acta Anaesthesiol Scand. 1992;36:270–5.

    Article  CAS  PubMed  Google Scholar 

  99. Anderson SK, Shaikh BA. Diclofenac in combination with opiate infusion after joint replacement surgery. Anesth Intensive Care. 1991;19:535–8.

    CAS  Google Scholar 

  100. Laitinen J, Nuutinen LS, Puranen J, Ranta P, Salomaki T. Effect of a non-steroidal anti-inflammatory drug, diclofenac, on haemostasis in patients undergoing total hip replacement. Acta Anaesthesiol Scand. 1992;36:486–9.

    Article  CAS  PubMed  Google Scholar 

  101. Grace D, Bunting H, Milligan KR, Fee JPH. Postoperative analgesia after co-administration of clonidine and morphine by the intrathecal route in patients undergoing hip replacement. Anesth Analg. 1995;80:86–91.

    CAS  PubMed  Google Scholar 

  102. Kandler D, Lisander B. Analgesic action of metoclopramide in prosthetic hip surgery. Acta Anaesthesiol Scand. 1993;37:49–53.

    Article  CAS  PubMed  Google Scholar 

  103. Anker-Moller E, Spangsberg N, Dahl JB, Christensen EF, Schultz P, Carlsson P. Continuous blockade of the lumbar plexus after knee surgery: a comparison of the plasma concentrations and analgesic effect of bupivacaine 0.250% and 0.125%. Acta Anaesthesiol Scand. 1990;34:468–72.

    Article  CAS  PubMed  Google Scholar 

  104. Capdevilla X, Macaire P, Dadure C, et al. Continuous psoas compartment block for postoperative analgesia after hip arthroplasty: new landmarks, technical guidelines and clinical evaluation. Anesth Analg. 2002;94:1606–13.

    Google Scholar 

  105. Williams DP, Longo SR, Cronin AJ. Continuous lumbar plexus analgesia via the fascia iliaca compartment after total hip arthroplasty. Am J Anesthesiol. 1998;25:177–80.

    Google Scholar 

  106. Solheim E, Strand T. Postoperative pain after anterior cruciate ligament reconstruction using a transligamentous approach. Am J Sports Med. 1993;21:507–9.

    Article  CAS  PubMed  Google Scholar 

  107. Van Essen EJ, Bovill JG, Ploeger EJ. Extradural clonidine does not potentiate analgesia produced by extradural morphine after meniscectomy. Br J Anaesth. 1991;66:237–41.

    Article  PubMed  Google Scholar 

  108. Anker-Moller E, Spangberg N, Dahl JB, Christensen EF, Schultz P, Carlsson P. Continuous blockade of the lumbar plexus after knee surgery: a comparison of the plasma concentrations and analgesic effect of bupivacaine 0.250% and 0.125%. Acta Anaesthesiol Scand. 1990;34:468–72.

    Article  CAS  PubMed  Google Scholar 

  109. Schultz P, Anker-Moller E, Dahl JB, Christensen EF, Spangberg N, Fauno P. Postoperative pain treatment after open knee surgery: continuous lumbar plexus block with bupivacaine versus epidural morphine. Reg Anesth. 1991;16:34–7.

    CAS  PubMed  Google Scholar 

  110. Goranson BD, Lang S, Cassidy JD, Dust WN, McKerrell J. A comparison of three regional anesthesia techniques for outpatient knee arthroscopy. Can J Anaesth. 1997;44:371–6.

    Article  CAS  PubMed  Google Scholar 

  111. Ringrose NH, Cross MJ. Femoral nerve block in knee joint surgery. Am J Sports Med. 1984;12:398–402.

    Article  CAS  PubMed  Google Scholar 

  112. Code WE, Yip RW, Erooney ME, Browne PM, Hertz T. Preoperative naproxen sodium reduces postoperative pain following arthroscopic knee surgery. Can J Anaesth. 1994;41:98–101.

    Article  CAS  PubMed  Google Scholar 

  113. McGuire DA, Sanders K, Hendricks SD. Comparison of ketorolac and opioid analgesics in postoperative ACL outpatient pain control. Arthroscopy. 1993;9:653–61.

    Article  CAS  PubMed  Google Scholar 

  114. Laitinen J, Nuutinen L, Kiiskila EL, Freudenthal Y, Ranta P, Karvonen J. Comparison of intravenous diclofenac, indomethacin and oxycodone as post-operative analgesics in patients undergoing knee surgery. Eur J Anesthesiol. 1992;9:29–34.

    CAS  Google Scholar 

  115. Pederson P, Nielsen KD, Jensen PE. The efficacy of na-naproxen after diagnostic and therapeutic arthroscopy of the knee joint. Arthroscopy. 1993;9:170–3.

    Article  Google Scholar 

  116. Rasmussen S, Thomsen S, Madsen SN, Rasmussen PJS, Simonsen OH. The clinical effect of naproxen sodium after arthroscopy of the knee: a randomized, double blind, prospective study. Arthroscopy. 1993;9:375–80.

    Article  CAS  PubMed  Google Scholar 

  117. Thwaites BK, Nigus DB, Bouska GW, Mongan PD, Ayala EF, Merrill GA. Intravenous ketorolac tromethamine worsens platelet function during knee arthroscopy under spinal anesthesia. Anesth Analg. 1996;82:1176–81.

    CAS  PubMed  Google Scholar 

  118. Thwaites BK, Nigus DB, Bouska GW, Mongan PD, Ayala EF, Merrill GA. Intravenous ketoroloc tromethamine does not worsen platelet function during knee arthroscopy under general anesthesia. Anesth Analg. 1995;81:119–24.

    CAS  PubMed  Google Scholar 

  119. Khoury GF, Chen ACN, Garland DE, Stein C. Intraarticular morphine, bupivacaine, and morphine/bupivacaine for pain control after knee videoarthroscopy. Anesthesiology. 1992;77:263–6.

    Article  CAS  PubMed  Google Scholar 

  120. Allen GC, St. Amand MA, Lui ACP, Johnson CH, Lindsay MP. Post-arthroscopy analgesia with intraarticular bupivacaine/morphine. Anesthesiology. 1993;79:475–80.

    Article  CAS  PubMed  Google Scholar 

  121. Gyrn JP, Olsen KS, Appelquist E, Chraemmer-Jorgensen B, Duus B, Berner Hansen L. Intra-articular bupivacaine plus adrenaline for arthroscopic surgery of the knee. Acta Anaesthesiol Scand. 1992;36:643–6.

    Article  CAS  PubMed  Google Scholar 

  122. White AP, Laurent S, Wilkinson DJ. Intra-articular and subcutaneous prilocaine with adrenaline for pain relief in day case arthroscopy of the knee joint. Ann R Coll Surg. 1990;72:350–2.

    CAS  Google Scholar 

  123. Joshi GP, McSwiney M, Hurson BJ, McCarroll SM, O’Rourke P. Effects of intraarticular morphine on analgesic requirements after anterior cruciate ligament repair. Reg Anesth. 1993;18:254–7.

    CAS  PubMed  Google Scholar 

  124. Joshi GP, McCarroll SM, Brady OH, Hurson BJ, Walsh G. Intra-articular morphine for pain relief after anterior cruciate ligament repair. Br J Anesth. 1993;70:87–8.

    Article  CAS  Google Scholar 

  125. Joshi GP, O’Brien TM, McCarroll Sm, Lenane P. Intraarticular injection following arthroscopy. Anesth Analg. 1993;76:333–6.

    CAS  PubMed  Google Scholar 

  126. Cepeda MS, Uribe C, Betancourt J, Rugeles J, Carr DB. Pain relief after knee arthroscopy: intraarticular morphine, intraarticular bupivacaine or subcutaneous morphine? Reg Anesth. 1997;22:233–8.

    Article  CAS  PubMed  Google Scholar 

  127. Adriani J, Zepernick R. Allergic reactions to local anesthetics. South Med J. 1981;74:694–703.

    Article  CAS  PubMed  Google Scholar 

  128. Assem ESK, Punnia-Moorthy A. Allergy to local anaesthetics: an approach to definitive diagnosis. Br Dent J. 1988;164:44–7.

    Article  CAS  PubMed  Google Scholar 

  129. Crampton RS. Methylparaben in lidocaine. JAMA. 1968;205:803.

    Article  CAS  PubMed  Google Scholar 

  130. Caro I. Contact allergy/photo allergy to glyceryl PABA and benzocaine. Contact Dermatitis. 1978;4:381–2.

    Article  CAS  PubMed  Google Scholar 

  131. Bircher AJ, Messmer SL, Surber C, Rufli T. Delayed-type hypersensitivity to subcutaneous lidocaine with tolerance to articaine: confirmation by in vivo and in vitro tests. Contact Dermatitis. 1996;34:387–9.

    Article  CAS  PubMed  Google Scholar 

  132. Du Pen SL, Petersen DG, et al. Infection during chronic epidural catheterization. Anesthesiology. 1990;73:905–9.

    Article  PubMed  Google Scholar 

  133. Carp H, Bailey S. The association between meningitis and dural puncture in bacteremic rats. Anesthesiology. 1992;76:739–42.

    Article  CAS  PubMed  Google Scholar 

  134. Berman RS, Eisele JH. Bacteremia, spinal anesthesia, and development of meningitis. Anesthesiology. 1978;48:376–7.

    Article  CAS  PubMed  Google Scholar 

  135. Owens EL, Kasten GW, Hessel EA. Spinal subarachnoid hematoma after lumbar puncture and heparinization: a case report, review of the literature, and discussion of anesthetic implications. Anesth Analg. 1986;65:1201–7.

    Article  CAS  PubMed  Google Scholar 

  136. Kehlet H, Dahl JB. The value of “multi-modal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg. 1993;77:1048–56.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John E. Tetzlaff M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Tetzlaff, J.E. (2013). Perioperative Pain Management and Orthopedic Surgery. In: Mandell, B. (eds) Perioperative Management of Patients with Rheumatic Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-2203-7_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-2203-7_2

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-2202-0

  • Online ISBN: 978-1-4614-2203-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics