Effectiveness of lidocaine patches for pain treatment after total knee arthroplasty

Abstract

BACKGROUND:Effective analgesic therapy in the postoperative period of total knee arthroplasty is essential for good surgical outcomes. The current trend is to use multimodal treatment, in which the use of patches with lidocaine as adjuvant therapy has an increasingly relevant role. OBJECTIVE: To investigate the potential benefits of lidocaine patch association with the basic analgesia regimen for pain relief during the postoperative period of total knee arthroplasty. METHOD: A retrospective cohort study was performed , with a total of 24 patients in each group, who underwent total knee arthroplasty. Pain levels using a visual analogue scale and opioid intake were controlled from the immediate postoperative to the end of a 28-day interval. RESULTS: During the postoperative period, pain was less intense in patients who used lidocaine patches. In these same patients, the doses of opioids needed to control pain were lower in 15 of the 28 days analyzed. The relative frequency of nausea was higher in the group that did not use adjuvant therapy. Patients older than 70 years and females predominated. CONCLUSION: Adjuvant treatment after total knee arthroplasty using lidocaine patches was effective in reducing pain and decreasing the use of opioids in the period analyzed, and represents a good addition to multimodal analgesic therapy.

Ultrasound-guided serratus plane block with continuous postoperative drug delivery system for acute nociceptive and neuropathic pain after mastectomy

“…A recent randomised controlled study conducted on 48 patients for total knee replacement investigated the analgesic effect of LP versus no patch, as an adjuvant to standard analgesics, for 28 postoperative days. The study concluded that LP was effective in reducing pain and decreasing tramadol consumption during the period of the study, and added an analgesic value when used with other multimodal analgesic modalities [23].…”

Efficacy of transdermal 4% lidocaine patches for postoperative pain management after arthroscopic rotator cuff repair: a prospective trial

“… 3 , 15 Sadigursky et al, who performed a trial evaluating the use of T5L patches after TKA, found that the T5L patches decreased narcotic consumption and postoperative pain. 14 Conversely, Khanna et al evaluated 53 patients after TKA and discovered that there was an increase in pain associated with T5L patch use. 10 The mechanism by which lidocaine patches alleviate pain in some musculoskeletal injuries, and not others, is likely secondary to the depth of the injured tissues and the ability of transdermal application to penetrate the soft tissues surrounding traumatized tissue.…”

“…A randomized trial evaluating the use of T5L after arthroplasty found decreased pain at 1 day, 2 days, 3 days, and 2 weeks postop, as well as decreasing opioid medication consumption. 14 In contrast, another study investigating the use of T5L during inpatient rehabilitation after total knee arthroplasty (TKA) found that there was actually an increase in pain associated with T5L patch use. 10 …”

Lidocaine patches for postcesarean pain control in obese women: a pilot randomized controlled trial

“…Based on the existing literature on the use of lidocaine patches after noncesarean surgeries, some studies applied the patches directly to the incisions, 38 but other studies demonstrated efficacy when patches were applied around the incision. 36,39,61,62 Thus, the application site may not have been the reason for the lack of efficacy. Second, lidocaine patches may be less effective for laparotomy incisions.…”