Higher doses of intraoperative analgesia are associated with lower levels of persistent pain and less analgesic consumption six months after total hip arthroplasty

Abstract

Our study suggests that lower doses of intraoperative analgesia are associated with higher levels of persistent postoperative pain. Persistent pain may be caused by intraoperative nociception, which is likely not adequately suppressed using current clinical standard analgesic measures.

Analgesic consumption trajectories in 8975 patients 1 year after fast‐track total hip or knee arthroplasty

“…In TKA patients with preoperative opioid use, about 18% had increased opioid consumption, corresponding to the well-known risk of persistent or even increased pain after TKA (Beswick et al, 2012). A recent prospective cohort study in THA also demonstrated continued unspecified analgesic use in 32% of patients, as well as a median pain level of 4/10 6 months after surgery (von Dincklage et al, 2018). However, their patients all had general total intravenous anaesthesia, whereas the use of neuraxial anaesthesia has been reported in about 90% of procedures in the departments contributing to our cohort (Bjerregaard et al, 2015).…”

The Effect of Patient Characteristics and Perioperative Conditions on Chronic Pain Developing After Lower Extremity Arthroplasty Interventions: A Retrospective Analysis of 3-Year Clinical Results

“…25 İntraoperatif yeterli analjezi yönetimi santral sensitizasyonu engelleyerek kronik ağrıyı önleyebilir. 26,27 Bu ilişki psikososyal faktörler varlığında bile mevcuttur. Güncel klinik standartlarla uygun anestezi ve analjezi sağlanmadığında PPP'nin intraoperatif nosisepsiyondan kaynaklanması mümkün gözükmektedir.…”

Retrospective assessment of the relationship between intraoperative nociception and postoperative analgesia requirements in dogs undergoing thoracic surgery

“…Several studies in human medicine have shown that both preoperative pain and acute postoperative pain are correlated with persistent postoperative pain 16–18 . The relation between intraoperative nociception and postoperative pain has been shown in hip surgery on humans.…”

“…The relation between intraoperative nociception and postoperative pain has been shown in hip surgery on humans. Titration of perioperative analgesic based on nociception reduces postoperative pain 17,19 . Given these correlations, assessing the presence of a connection between intraoperative nociception and postoperative pain might prove beneficial, by allowing to identify patients with likely higher postoperative analgesic requirements, which could help guide the use of postoperative analgesia.…”