Postoperative Pain Management Strategies in Hip Arthroscopy

Abstract

Purpose of Review Hip arthroscopy is a rapidly growing field due to its significant diagnostic and therapeutic value in the management of numerous hip disorders. Adequate control of postoperative pain in patients undergoing hip arthroscopy continues to be a challenging and evolving area in orthopedics. In the absence of standardized protocols for pain management in these patients, a variety of different approaches have been utilized in an effort to find a regimen that is effective at reducing postoperative pain, narcotic consumption, and cost to the patient and healthcare system. The purpose of this article, therefore, is to provide a comprehensive review of current literature regarding postoperative pain management techniques in patients undergoing hip arthroscopy. Recent Findings Recent literature demonstrates the importance of a multimodal approach to treat postoperative pain in patients undergoing hip arthroscopy. When a peripheral nerve block or intraoperative anesthetic is used in combination with a pre-and postoperative analgesic medication regimen, patients report less pain and postoperative narcotic consumption. Patient-reported pain scores and postoperative opioid use were similar between the different modalities, however, postoperative complications appear to be less in groups receiving intra-articular (IA) injection or local anesthetic infiltration (LAI) compared to peripheral nerve blocks. Summary In summary, we present evidence that intraoperative techniques, such as IA injection or LAI, in conjunction with preand postoperative pain medications, offers an effective multimodal strategy for treating postoperative pain following hip arthroscopy. This topic is of increasing importance due to the need for cost-effective strategies of managing pain and decreasing opioid consumption following hip arthroscopy.

Prospective Single-Blinded Randomized Controlled Trial Comparing Pericapsular Injection Versus Lumbar Plexus Peripheral Nerve Block for Hip Arthroscopy

“…Despite ongoing research, there exists no identifiable gold standard with regard to the optimal method for management of postoperative pain after hip arthroscopy. 9,28 Interventional modalities used by surgeons are numerous and include lumbar plexus blockade, peripheral nerve blockade, field block, or intra- or pericapsular injection. Various pharmacologic interventions have been investigated as well.…”

Commentary: Postoperative Pain Management Strategies in Hip Arthroscopy

“…The purpose of Postoperative Pain Management Strategies in Hip Arthroscopy [1] was to provide an up to date comprehensive review of current literature regarding postoperative pain management techniques in patients undergoing hip arthroscopy. In addition, it provides a source that orthopedic surgeons can reference to determine which hip arthroscopy pain management technique, or combination thereof, is best for their practice and patients.…”

Study of pain level control targets after arthroscopic surgery

“…The bene ts of arthroscopic surgery over traditional open surgery include minimal surgical trauma and tissue damage and rapid patient recovery, but postoperative pain control following arthroscopic surgery remains unsatisfactory [12]. Pain should be controlled after arthroscopic surgery to a level that will both be acceptable to the patient and not affect their physiological function and postoperative rehabilitation.…”