Analgesic Techniques in Hip and Knee Arthroplasty: From the Daily Practice to Evidence-Based Medicine

Abstract

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are major orthopedic surgery models, addressing mainly ageing populations with multiple comorbidities and treatments, ASA II–IV, which may complicate the perioperative period. Therefore effective management of postoperative pain should allow rapid mobilization of the patient with shortening of hospitalization and social reintegration. In our review we propose an evaluation of the main analgesics models used today in the postoperative period. Their comparative analysis shows the benefits and side effects of each of these methods and guides us to how to use evidence-based medicine in our daily practice.

Empowering knowledge and Quality of Recovery after hip or knee replacement

“…It has been concluded that analgesic needs are higher for patients undergoing knee replacement than those undergoing hip replacement. This means that patients undergoing hip replacement have less postoperative pain (Anastase et al 2014). It is possible that the smaller differences in our study are related to less pain, since new analgesia methods and operative techniques aimed at early mobilization and shorter hospital stay have been developed during recent years (Anastase et al 2014).…”

“…This means that patients undergoing hip replacement have less postoperative pain (Anastase et al 2014). It is possible that the smaller differences in our study are related to less pain, since new analgesia methods and operative techniques aimed at early mobilization and shorter hospital stay have been developed during recent years (Anastase et al 2014). It is also possible that the multi-centre, cross-cultural design might hide differences in QoR within and between the countries.…”

“…This policy to reduce costs, but also medical advances and new approaches to care, have resulted in shorter hospital stays after hip and knee replacements, from 15 days during the 80s to 4-6 days today (Anastase et al 2014, Mäkelä et al 2014, Sundberg et al 2014. With today's shorter hospital stays the patients need to take more responsibility for their own recovery.…”

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“…LIA and FNB pain management methods are both used in TKA surgeries at the clinic. Multimodal analgesia was used in TKA and is critical for improvement of the rehabilitation and reduction of the hospitalization days [1,2,4]. Among these methods, FNB is considered as the gold standard because of its effectiveness [9].…”

“…Optimal perioperative analgesia will enhance functional recovery, including timely recovery of knee mobility, reduce length of hospital stay and reduce postoperative morbidity [1,2]. Thus, researchers recurrently study pain treatment of the surgery.…”