The impact of patients controlled analgesia undergoing orthopedic surgery

Dias, Andrew; Rinaldi, Tathyana; Barbosa, Luciana Gardin

doi:10.1016/j.bjane.2013.06.023

Cited by 5 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, these adverse effects are less severe than those caused by conventional opioid treatment . PCA is safe and effective for treating moderate to severe pain and has become increasingly popular for use in patients undergoing TKA. Currently, opioid drugs are commonly administered by PCA, adding to multimodal analgesia.…”

Section: Postoperative Analgesic Regimensmentioning

confidence: 99%

Postoperative Pain Management in Total Knee Arthroplasty

Xiao

2019

Orthopaedic Surgery

192

152

View full text Add to dashboard Cite

Total knee arthroplasty (TKA) is one of the most common surgeries performed to relieve joint pain in patients with end‐stage osteoarthritis or rheumatic arthritis of the knee. However, TKA is followed by moderate to severe postoperative pain that affects postoperative rehabilitation, patient satisfaction, and overall outcomes. Historically, opioids have been widely used for perioperative pain management of TKA. However, opioids are associated with undesirable adverse effects, such as nausea, respiratory depression, and retention of urine, which limit their application in daily clinical practice. The aim of this review was to discuss the current postoperative pain management regimens for TKA. Our review of the literature demonstrated that multimodal analgesia is considered the optimal regimen for perioperative pain management of TKA and improves clinical outcomes and patient satisfaction, through a combination of several types of medications and delivery routes, including preemptive analgesia, neuraxial anesthesia, peripheral nerve blockade, patient‐controlled analgesia and local infiltration analgesia, and oral opioid/nonopioid medications. Multimodal analgesia provides superior pain relief, promotes recovery of the knee, and reduces opioid consumption and related adverse effects in patients undergoing TKA.

show abstract

Section: Postoperative Analgesic Regimensmentioning

confidence: 99%

Postoperative Pain Management in Total Knee Arthroplasty

Xiao

2019

Orthopaedic Surgery

192

152

View full text Add to dashboard Cite

show abstract

“…Despite the multimodal approach, some patients may develop intractable postoperative pain [ 4 , 5 ]. Currently, certain doses of opioids through patient-controlled analgesia (PCA) devices are often used for postoperative analgesia after THA [ 6 , 7 ]. Although not every patient needs the additional non-opioid, the use of an additional non-opioid agent is often recommended, given the various side effects of analgesic opioids [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The use of gabapentin in the management of postoperative pain after total hip arthroplasty: a meta-analysis of randomised controlled trials

Han

Jiang

et al. 2016

J Orthop Surg Res

View full text Add to dashboard Cite

BackgroundPain management after total hip arthroplasty (THA) varies and has been widely studied in recent years. Gabapentin as a third-generation antiepileptic drug that selectively affects the nociceptive process has been used for pain relief after THA. This meta-analysis was conducted to examine the efficacy of gabapentin in THA.MethodsAn electronic-based search was conducted using the following databases: PubMed, EMBASE, Ovid MEDLINE, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomised controlled trials (RCTs) involving gabapentin and a placebo for THA were included. The meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.ResultsFive trials met the inclusion criteria. The cumulative narcotic consumption and the visual analogue scale (VAS) scores at 24 and 48 h postoperatively were used for postoperative pain assessment. There was a significant decrease in morphine consumption at 24 h (P = 0.00). Compared with the control group, the VAS score (at rest) at 48 h was less in the gabapentin group (P = 0.00).ConclusionThe administration of gabapentin is effective in decreasing postoperative narcotic consumption and the VAS score.

show abstract

“…One of the most effective and commonly used methods for postoperative pain management is the intravenous patient-controlled analgesia (IV PCA) after an orthopedic surgery. 3 Studies have shown that this method is healthy and effective in the treatment of moderate to severe pain. 4 The use of this analgesic technique is often done in severe pain such as after orthopedic surgery pain, or chronic pain such as patients with advanced malignancies.…”

Section: Ethical Publication Statementmentioning

confidence: 99%

Comparison of Fentanyl plus different doses of dexamethasone with Fentanyl alone on postoperative pain, nausea, and vomiting after lower extremity orthopedic surgery

2022

View full text Add to dashboard Cite

Intravenous patient controlled analgesia (PCA) with opioids to provide perioperative analgesia is commonly used after orthopedic surgery, but have side-effects. Addition of adjutant drugs results in reducing the side-effects and the dosage of opioids. The aim of current study was to evaluation the analgesic efficacy of combination of fentanyl and dexamethasone (8 and 16 mg) in compared with fentanyl alone in patients undergoing orthopedic surgery of the lower extremity. In a double-blind clinical trial, 102 patients were randomly allocated to receive PCA, which included: F+S group (fentanyl 1 mcg/ml + isotonic saline), F+8mD group (fentanyl 1 mcg/ml + dexamethasone 8 mg/ml), and F+16mD group (fentanyl 1 mcg/ml + dexamethasone 16 mg/ml). Anesthesia technique and rescue analgesia regimen were standardized. Postoperatively, pain was assessed based on visual analog scale (VAS). In addition, we evaluated the postoperative nausea and vomiting (POVN) in different groups. In over the post-operative period, the mean VAS-score was significantly lower in the F+16mD group than the F+S and the F+8mD groups (p<0.001 and p<0.01, respectively). In addition, the incidence of PONV significantly was lower in the F+18mD group than the F+S group (p<0.05). We conclude that the addition of preoperative intravenous high dose of dexamethasone (16 mg) to fentanyl was effective in reducing postoperative pain and PONV after orthopedic surgery of the lower extremity.

show abstract

The impact of patients controlled analgesia undergoing orthopedic surgery

Cited by 5 publications

References 24 publications

Postoperative Pain Management in Total Knee Arthroplasty

Postoperative Pain Management in Total Knee Arthroplasty

The use of gabapentin in the management of postoperative pain after total hip arthroplasty: a meta-analysis of randomised controlled trials

Comparison of Fentanyl plus different doses of dexamethasone with Fentanyl alone on postoperative pain, nausea, and vomiting after lower extremity orthopedic surgery

Contact Info

Product

Resources

About