Research Article
Volume 12 Issue 2 - 2021
Pain Management Modalities in Total Knee Arthroplasty- A Research Article
Ranjeet Kumar*, Muhammad Umar, Imamuddin and Raja Shahzad
South City Hospital, Pakistan, Pakistan
*Corresponding Author: Ranjeet Kumar, South City Hospital, Pakistan.
Received: November 18, 2020; Published: January 27, 2021




Abstract

Add up to knee arthroplasty (TKA) is one of the foremost common surgeries performed to calm joint torment in patients with end‐stage osteoarthritis or rheumatic joint pain of the knee. In any case, TKA is taken after by direct to serious postoperative torment that influences postoperative restoration, understanding fulfillment, and in general results. Verifiably, opioids have been broadly utilized for perioperative torment administration of TKA. Be that as it may, opioids are related with undesirable antagonistic impacts, such as sickness, respiratory sadness and maintenance of pee, which constrain their application in day by day clinical hone. The point of this audit was to examine the current postoperative torment administration regimens for TKA.

Our survey of the writing illustrated that multimodal absence of pain is considered the ideal regimen for perioperative torment administration of TKA and moves forward clinical results and persistent fulfillment, through a combination of a few sorts of solutions and conveyance courses, counting preemptive absence of pain, neuraxial anesthesia, fringe nerve barricade, patient‐controlled absence of pain and neighborhood penetration absence of pain, and verbal opioid/nonopioid medicines. Multimodal absence of pain gives predominant torment help, advances recuperation of the knee, and decreases opioid utilization and related unfavorable impacts in patients experiencing TKA.

Keywords: Knee Joint Pain; Multimodal Analgesia; Postoperative Pain; Total Knee Arthroplasty

References

  1. Aso K., et al. “Additional benefit of local infiltration of analgesia to femoral nerve block in total knee arthroplasty: double‐blind randomized control study”. Knee Surgery, Sports Traumatology, Arthroscopy 27 (2019): 2368-2374.
  2. Seo SS., et al. “Comparison of the effect of continuous femoral nerve block and adductor canal block after primary total knee arthroplasty”. Clinics in Orthopedic Surgery 9 (2017): 303-309.
  3. Gaffney CJ., et al. “Perioperative pain management in hip and knee arthroplasty”. Orthopedic Clinics of North America 48 (2017): 407-419.
  4. Dimaculangan D., et al. “Periarticular injection and continuous femoral nerve block versus continuous femoral nerve block alone on postoperative opioid consumption and pain control following total knee arthroplasty: randomized controlled trial”. Journal of Clinical Orthopaedics and Trauma 10 (2019): 81-86.
  5. Moucha CS., et al. “Current strategies in anesthesia and analgesia for total knee arthroplasty”. The Journal of the American Academy of Orthopaedic Surgeons 24 (2016): 60-73.
  6. Pogatzki‐Zahn EM and Zahn PK. “From preemptive to preventive analgesia”. Current Opinion in Anesthesiology 19 (2006): 551-555.
  7. Grape S and Tramèr MR. “Do we need preemptive analgesia for the treatment of postoperative pain?” Best Practice and Research Clinical Anaesthesiology 21 (2007): 51-63.
  8. Bian YY., et al. “Role of parecoxib sodium in the multimodal analgesia after total knee arthroplasty: a randomized double‐blinded controlled trial”. Orthopaedic Surgery 10 (2018): 321-327.
  9. Jianda X., et al. “Impact of preemptive analgesia on inflammatory responses and rehabilitation after primary total knee arthroplasty: a controlled clinical study”. Scientific Reports 6 (2016): 30354.
  10. Lubis AMT., et al. “Preemptive analgesia in total knee arthroplasty: comparing the effects of single dose combining celecoxib with pregabalin and repetition dose combining celecoxib with Pregabalin: double‐blind controlled clinical trial”. Pain Research and Treatment (2018): 3807217.
  11. Xu Z., et al. “Preemptive analgesia by using celecoxib combined with tramadol/APAP alleviates post‐operative pain of patients undergoing total knee arthroplasty”. The Physician and Sportsmedicine 45 (2017): 316-322.
  12. Bedard NA., et al. “Opioid use after total knee arthroplasty: trends and risk factors for prolonged use”. The Journal of Arthroplasty 32 (2017): 2390-2394.
  13. Dwyer MK., et al. “Characterization of post‐operative opioid use following total joint arthroplasty”. The Journal of Arthroplasty 33 (2018): 668-672.
  14. Hadlandsmyth K., et al. “Risk for prolonged opioid use following total knee arthroplasty in veterans”. The Journal of Arthroplasty 33 (2018): 119-123.
  15. Smith SR., et al. “Impact of preoperative opioid use on total knee arthroplasty outcomes”. Journal of Bone and Joint Surgery American 99 (2017): 803-808.
  16. Manalo JPM., et al. “Preoperative opioid medication use negatively affect health related quality of life after total knee arthroplasty”. Knee 25 (2018): 946-951.
  17. Hina N., et al. “Hyperalgesia induced by low‐dose opioid treatment before orthopaedic surgery: an observational case‐control study”. European Journal of Anaesthesiology 32 (2015): 255-261.
  18. Trang T., et al. “Pain and poppies: the good, the bad, and the ugly of opioid analgesics”. The Journal of Neuroscience 35 (2015): 13879-13888.
  19. Weick J., et al. “Preoperative opioid use is associated with higher readmission and revision rates in total knee and total hip arthroplasty”. Journal of Bone and Joint Surgery American 100 (2018): 1171-1176.
  20. Nguyen LC., et al. “Preoperative reduction of opioid use before total joint arthroplasty”. The Journal of Arthroplasty 31 (2016): 282-287.
  21. Du X and Gu J. “The efficacy and safety of parecoxib for reducing pain and opioid consumption following total knee arthroplasty: a meta‐analysis of randomized controlled trials”. International Journal of Surgery 59 (2018): 67-74.
  22. Lin J., et al. “Perioperative administration of selective cyclooxygenase‐2 inhibitors for postoperative pain management in patients after total knee arthroplasty”. The Journal of Arthroplasty 28 (2013): 207-213.
  23. Munteanu AM., et al. “Is there any analgesic benefit from preoperative vs. postoperative administration of etoricoxib in total knee arthroplasty under spinal anaesthesia? a randomised double‐blind placebo‐controlled trial”. European Journal of Anaesthesiology 33 (2016): 840-845.
  24. Zhu YZ., et al. “Parecoxib prevents early postoperative cognitive dysfunction in elderly patients undergoing total knee arthroplasty: a double‐blind, randomized clinical consort study”. Medicine 95 (2016): e4082.
  25. Zhu Y., et al. “Protective effect of celecoxib on early postoperative cognitive dysfunction in geriatric patients”. Frontiers in Neurology 9 (2018): 633.
  26. Greimel F., et al. “Matched‐pair analysis of local infiltration analgesia in total knee arthroplasty: patient satisfaction and perioperative pain management in 846 cases”. The Journal of Knee Surgery (2018).
  27. Zhang Z and Shen B. “Effectiveness and weakness of local infiltration analgesia in total knee arthroplasty: a systematic review”. Journal of International Medical Research 46 (2018): 4874-4884.
  28. Zhang LK., et al. “Comparison of periarticular local infiltration analgesia with femoral nerve block for total knee arthroplasty: a meta‐analysis of randomized controlled trials”. The Journal of Arthroplasty 33 (2018): 1972-1978.
  29. Wall PDH., et al. “A pragmatic randomised controlled trial comparing the efficacy of a femoral nerve block and periarticular infiltration for early pain relief following total knee arthroplasty”. The Bone and Joint Journal 99‐B (2017): 904-911.
  30. Hu B., et al. “Local infiltration analgesia versus regional blockade for postoperative analgesia in total knee arthroplasty: a meta‐analysis of randomized controlled trials”. Pain Physician 19 (2016): 205-214.
  31. Sardana V., et al. “Adductor canal block or local infiltrate analgesia for pain control after total knee arthroplasty? A systematic review and meta‐analysis of randomized controlled trials”. The Journal of Arthroplasty 34 (2019): 183-189.
  32. Snyder MA., et al. “Improving total knee arthroplasty perioperative pain management using a periarticular injection with bupivacaine liposomal suspension”. Arthroplast Today 2 (2016): 37-42.
  33. Heim EA., et al. “Use of liposomal bupivacaine instead of an epidural can improve outcomes following total knee arthroplasty”. The Journal of Surgical Orthopaedic Advances 24 (2015): 230-234.
  34. Alijanipour P., et al. “Periarticular injection of liposomal bupivacaine offers no benefit over standard bupivacaine in total knee arthroplasty: a prospective, randomized, controlled trial”. The Journal of Arthroplasty 32 (2017): 628-634.
  35. Mont MA., et al. “Local infiltration analgesia with liposomal bupivacaine improves pain scores and reduces opioid use after total knee arthroplasty: results of a randomized controlled trial”. The Journal of Arthroplasty 33 (2018): 90-96.
  36. Talmo CT., et al. “Prospective randomized trial comparing femoral nerve block with intraoperative local anesthetic injection of liposomal bupivacaine in total knee arthroplasty”. The Journal of Arthroplasty 33 (2018): 3474-3478.
  37. Seangleulur A., et al. “The efficacy of local infiltration analgesia in the early postoperative period after total knee arthroplasty: a systematic review and meta‐analysis”. European Journal of Anaesthesiology 33 (2016): 816-831.
  38. Monahan A., et al. “Regional analgesia added to general anesthesia compared with general anesthesia plus systemic analgesia for cardiac surgery in children: a systematic review and meta‐analysis of randomized clinical trials”. Anesthesia and Analgesia 128 (2019): 130-136.
  39. Treschan TA., et al. “The effects of epidural and general anesthesia on tissue oxygenation”. Anesthesia and Analgesia 96 (2003): 1553-1557.
  40. Pugely AJ., et al. “Differences in short‐term complications between spinal and general anesthesia for primary total knee arthroplasty”. Journal of Bone and Joint Surgery America 95 (2013): 193-199.
  41. Park YB., et al. “Comparison of short‐term complications of general and spinal anesthesia for primary unilateral total knee arthroplasty”. Knee Surgery and Related Research 29 (2017): 96-103.
  42. Mahan MC., et al. “Mepivacaine spinal anesthesia facilitates rapid recovery in total knee arthroplasty compared to bupivacaine”. The Journal of Arthroplasty 33 (2018): 1699-1704.
  43. Block BM., et al. “Efficacy of postoperative epidural analgesia: a meta‐analysis”. The Journal of the American Medical Association 290 (2003): 2455-2463.
  44. Koh JC., et al. “Postoperative pain and patient‐controlled epidural analgesia‐related adverse effects in young and elderly patients: a retrospective analysis of 2,435 patients”. Journal of Pain Research 10 (2017): 897-904.
  45. Fedriani de Matos JJ., et al. “Effectiveness and safety of continuous ultrasound‐guided femoral nerve block versus epidural analgesia after total knee arthroplasty”. Revista Española de Anestesiología y Reanimación 64 (2017): 79-85.
  46. Kasture S and Saraf H. “Epidural versus intra‐articular infusion analgesia following total knee replacement”. Journal of Orthopaedic Surgery 23 (2015): 287-289.
  47. Li C., et al. “Local infiltration anesthesia versus epidural analgesia for postoperative pain control in total knee arthroplasty: a systematic review and meta‐analysis”. Journal of Orthopaedic Surgery and Research 13 (2018): 112.
  48. Fowler SJ., et al. “Epidural analgesia compared with peripheral nerve blockade after major knee surgery: a systematic review and meta‐analysis of randomized trials”. British Journal of Anaesthesia 100 (2008): 154-164.
  49. Dixit V., et al. “Effectiveness of continuous versus single injection femoral nerve block for total knee arthroplasty: a double blinded, randomized trial”. Knee 25 (2018): 623-630.
  50. Chan EY., et al. “Femoral nerve blocks for acute postoperative pain after knee replacement surgery”. Cochrane Database of Systematic Reviews 13 (2014): CD009941.
  51. Charous MT., et al. “Continuous femoral nerve blocks: varying local anesthetic delivery method (bolus versus basal) to minimize quadriceps motor block while maintaining sensory block”. Anesthesiology 115 (2011): 774-781.
  52. Li D and Ma GG. “Analgesic efficacy and quadriceps strength of adductor canal block versus femoral nerve block following total knee arthroplasty”. Knee Surgery, Sports Traumatology, Arthroscopy 24 (2016): 2614-2619.
  53. Karkhur Y., et al. “A comparative analysis of femoral nerve block with adductor canal block following total knee arthroplasty: a systematic literature review”. Journal of Anaesthesiology Clinical Pharmacology 34 (2018): 433-438.
  54. Tan Z., et al. “A comparison of adductor canal block and femoral nerve block after total‐knee arthroplasty regarding analgesic effect, effectiveness of early rehabilitation, and lateral knee pain relief in the early stage”. Medicine 97 (2018): e13391.
  55. Shah NA., et al. “Adductor canal blockade following total knee arthroplasty‐continuous or single shot technique? Role in postoperative analgesia, ambulation ability and early functional recovery: a randomized controlled trial”. The Journal of Arthroplasty 30 (2015): 1476-1481.
  56. Rantasalo MT., et al. “Randomised controlled study comparing general and spinal anaesthesia with and without a tourniquet on the outcomes of total knee arthroplasty: study protocol”. BMJ Open 8 (2018): e025546.
  57. Yik JH., et al. “Perioperative pregabalin does not reduce opioid requirements in total knee arthroplasty”. Knee Surgery, Sports Traumatology, Arthroscopy 27 (2019): 2104-2110.
  58. Ryu JH., et al. “Effects of palonosetron for prophylaxis of postoperative nausea and vomiting in high‐risk patients undergoing total knee arthroplasty: a prospective, randomized, double‐blind, placebo‐controlled study”. PLoS One 13 (2018): e0196388.
  59. Borckardt JJ., et al. “Prefrontal versus motor cortex transcranial direct current stimulation (tDCS) effects on post‐surgical opioid use”. Brain Stimulation 10 (2017): 1096-1101.
  60. Song MH., et al. “Peri‐articular injections of local anaesthesia can replace patient‐controlled analgesia after total knee arthroplasty: a randomised controlled study”. International Orthopaedics 40 (2016): 295-299.
  61. Walder B., et al. “Efficacy and safety of patient‐controlled opioid analgesia for acute postoperative pain. A quantitative systematic review”. Acta Anaesthesiologica Scandinavica 45 (2001): 795-804.
  62. Dias AS., et al. “The impact of patients controlled analgesia undergoing orthopedic surgery”. The Brazilian Journal of Anesthesiology 66 (2016): 265-271.
  63. Novello‐Siegenthaler A., et al. “Ultrasound‐guided continuous femoral nerve block: a randomized trial on the influence of femoral nerve catheter orifice configuration (six‐hole versus end‐hole) on post‐operative analgesia after total knee arthroplasty”. BMC Anesthesiology 18 (2018): 191.
  64. Kim DH., et al. “Addition of infiltration between the popliteal artery and the capsule of the posterior knee and adductor canal block to periarticular injection enhances postoperative pain control in total knee arthroplasty: a randomized controlled trial”. Anesthesia and Analgesia 129 (2019): 526-535.
  65. Tong QJ., et al. “Comparing adductor canal block with local infiltration analgesia in total knee arthroplasty: a prospective, blinded and randomized clinical trial”. Journal of Clinical Anesthesia 46 (2018): 39-43.
  66. McCarthy D., et al. “A comparison of the analgesic efficacy of local infiltration analgesia vs. intrathecal morphine after total knee replacement: a randomised controlled trial”. European Journal of Anaesthesiolog 36 (2019): 264-271.
  67. Koniuch KL., et al. “Serum ropivacaine levels after local infiltration analgesia during total knee arthroplasty with and without adductor canal block”. Regional Anesthesia and Pain Medicine (2019).
Citation: Ranjeet Kumar., et al. “Pain Management Modalities in Total Knee Arthroplasty- A Research Article”.EC Orthopaedics 12.2 (2021): 04-14.

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