Analgesic Techniques After Total Hip Arthroplasty

Yeap, Yar Luan; Butterworth, John F.

doi:10.1213/ane.0b013e31821aa46a

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…For example, preoperative education can shorten hospital stays11 and reduce postoperative pain 12. Several studies have found that pre-emptive analgesia allows more rapid mobilisation and return of function 13 14. Multiple studies have found that rapid mobilisation on the day of surgery (typically 2 to 6 hours after surgery) reduces length of stay and improves function 15–17.…”

Section: Introductionmentioning

confidence: 99%

Relationship between exposure to the natural environment and recovery from hip or knee arthroplasty: a New Zealand retrospective cohort study

2019

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ObjectivesDetermine whether patients who live in greener and more walkable neighbourhoods live longer, and take fewer opioids, following hip or knee arthroplasty.DesignRetrospective cohort study.SettingResidential environment following surgery at one of 54 New Zealand hospitals.ParticipantsAll people who received a total hip or knee arthroplasty at a publicly-funded hospital in New Zealand in 2006 and 2007 (7449 hip arthroplasties and 6558 knee arthroplasties).Primary and secondary outcome measureTime to all-cause mortality and number of postsurgical opioid prescriptions.ResultsPatients who lived in greener neighbourhoods, as measured by the Normalised Difference Vegetation Index, lived longer following hip or knee arthroplasty (standardised OR: 0.95, 95% CI 0.92 to 0.99). However, when we estimated separate hip-arthroplasty-only and knee-arthroplasty-only models, greenness was only significantly associated with greater longevity following hip arthroplasty. Similarly, patients who lived in greener neighbourhoods took fewer opioids in the 12 months following hip or knee arthroplasty (standardised OR: 0.97, 95% CI 0.95 to 0.99), but in separate hip-arthroplasty-only and knee-arthroplasty-only models, greenness was only significantly associated with lower opioid use following hip arthroplasty. Walkability was not significantly associated with postsurgical opioid use or postsurgical longevity. All ORs were adjusted for sex, ethnicity, age, presurgical chronic health conditions, presurgical opioid use, social deprivation and length of hospital stay.ConclusionsConsistent with the literature on enhanced-recovery programme, people who lived in greener neighbourhoods took fewer opioids, and lived longer, following hip arthroplasty. Improving access to the natural environment may therefore be an effective component of postsurgical recovery programme.

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Section: Introductionmentioning

confidence: 99%

Relationship between exposure to the natural environment and recovery from hip or knee arthroplasty: a New Zealand retrospective cohort study

2019

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“…[ 2 ] A key factor for success of THA has been early mobilization within as little as 48 h in “fast track” cases. [ 3 ] Contribution of adequate postoperative pain relief toward early mobilization is of paramount importance and undeniable. [ 3 ]…”

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confidence: 99%

“…Certain of these such as femoral and even transmuscular quadratus lumborum can be associated with upto 90% incidence of quadriceps weakness. [ 7 8 ] Contribution of quadriceps weakness to risk of fall and delayed ambulation would be worrisome, offsetting the advantage of analgesic efficacy by delaying recovery. [ 5 ]…”

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confidence: 99%

“…Thus, the use of peripheral nerve blocks would also be limited, as is general anaesthesia, to those with contraindication to spinal block such as coagulopathy or obstructive sleep apnea. [ 7 ] In the presence of a coagulopathy, the preference again would be for superficial peripheral nerve blocks rather than deeper ones such as lumbar plexus or transmuscular quadratus lumborum block that are fraught with the same limitations as for neuraxial blocks and hence are best avoided. [ 7 ]…”

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Total hip arthroplasty and peripheral nerve blocks: Limited but salient role?

Tyagi

Salhotra

2018

J Anaesthesiol Clin Pharmacol

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Ultrasound‐guided femoral nerve block and intravenous fentanyl in pain management of the patients with hip fracture: a prospective, randomized, single blinded clinical trial

Mayel

Foroughian

Zamani

et al. 2022

Acute Medicine & Surgery

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Aim Proximal femoral fracture is a painful condition. Pain alleviation is a treatment cornerstone to both comfort the patient and reduce adverse effects. This study aimed to evaluate and compare ultrasound‐guided femoral nerve block and intravenous fentanyl administration in relieving the pain of patients with hip fractures. Methods The present interventional clinical trial was conducted on 40 patients referred to Shahid‐Bahonar Hospital with unilateral isolated proximal femur fracture and American Society of Anesthesiologists I and II. The patients were randomly divided into two groups: intravenous fentanyl and ultrasound‐guided femoral nerve block for pain management. Pain severity was assessed by a numerical rating scale before and after the intervention in both groups and the groups were then compared. Results Forty patients were enrolled in to study; 27 (67.5%) were male. There was no significant difference in demographic variables between the two groups. Fourteen (35%) were older than 80 years. Pain significantly decreased three scores compared to the pre‐intervention level in both groups (95% confidence interval, 2–4). This was slightly higher in the femoral nerve block group. The largest strength of association for age and numerical rating scale of pain was found in the differences between the pre‐intervention and after‐intervention in femoral nerve block group ( r = −0.775, P < 0.001). Conclusion We found similar pain severity between the two groups. Considering the possible side effects of fentanyl, an ultrasound‐guided femoral nerve block shows may provide safer pain control and may be particularly suitable for patients with opioid dependence.

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Analgesic Techniques After Total Hip Arthroplasty

Cited by 6 publications

References 10 publications

Relationship between exposure to the natural environment and recovery from hip or knee arthroplasty: a New Zealand retrospective cohort study

Relationship between exposure to the natural environment and recovery from hip or knee arthroplasty: a New Zealand retrospective cohort study

Total hip arthroplasty and peripheral nerve blocks: Limited but salient role?

Ultrasound‐guided femoral nerve block and intravenous fentanyl in pain management of the patients with hip fracture: a prospective, randomized, single blinded clinical trial

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