Novel multimodal analgesia protocol following whole knee arthroplasty gives ache aid with out opioids

A examine led by Vinod Dasa, MD, Professor of Orthopaedics at LSU Health New Orleans School of Medicine, studies {that a} novel surgical ache administration technique following whole knee arthroplasty (TKA), or whole knee alternative, supplied ache aid with out opioids. The researchers additionally discovered that altering prescriptions for opioids at discharge from automated to upon request dramatically decreased opioid use. Their outcomes are printed within the Journal of Experimental Orthopaedics.

“About 70% of opioid-naïve sufferers wanted solely Tylenol and anti inflammatory drugs to handle their ache,” notes Dr. Dasa. “Opioid use in well being care is enhancing however stays troublesome to handle. Surgical ache was lengthy considered unavoidable, requiring a considerable amount of ache drugs. Creating revolutionary methods to reinforce surgical restoration by lowering ache and eliminating opioids may also help resolve a few of our greatest challenges.”

The 144 sufferers within the retrospective examine acquired the identical multimodal analgesia protocol apart from postoperative opioid prescribing. The novel multimodal analgesia routine included percutaneous cryo-neurolysis, a long-acting nerve block, about 5 days earlier than surgical procedure. Immediately earlier than surgical procedure, sufferers acquired a single dose of 150 mg pregabalin, 200 mg celecoxib, and 1000 mg intravenous (IV) acetaminophen. Upon discharge, all sufferers had been suggested 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, “More than half of all TKA sufferers and 72% of opioid-naïve sufferers who had been handled with a multimodal ache protocol designed to attenuate opioid use for as much as 3 months, and acquired opioids solely upon request after surgical procedure, recovered from TKA with out using any opioids and any worsening of self-reported ache or knee-related issues in contrast with sufferers who acquired an opioid prescription mechanically upon discharge.”

The authors additionally included Drs. Amy Bronstone and Peter Yager at LSU Health New Orleans School of Medicine’s Department of Orthopaedics, Dr. Claudia Leonardi, Assistant Professor of Behavioral and Community Health Sciences at LSU Health New Orleans School of Public Health and LSU Health New Orleans medical college students Leland van Deventer and Matthew Bennett.