RETRACTED: Effect of initiating a preventative multimodal analgesic regimen upon long-term patient outcomes after anterior cruciate ligament reconstruction for same-day surgery: A 1200-patient case series

Reuben, Scott S.; Gutta, Srinivasa; Maciolek, Holly; Sklar, Joseph H.; Redford, James

doi:10.1016/j.acpain.2005.05.002

Cited by 16 publications

(5 citation statements)

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“…The use of effective perioperative multimodal pharmacological analgesia (paracetamol, opioids, cyclo‐oxygenase‐2 (COX‐2) inhibitors, ketamine and clonidine) in addition to afferent neural blockade can potentially prevent central neuroplasticity 1 . For example, in anterior cruciate ligament reconstruction surgery, patients who received multimodal analgesic techniques were more likely to return to their pre‐injury level of activity (including full sports participation) 17 …”

Section: Perioperative and Multimodal Analgesiamentioning

confidence: 99%

Post‐surgical Neuropathic Pain

Shipton

2008

ANZ Journal of Surgery

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Surgeons and anaesthetists are involved in Pain Medicine, as they have a responsibility to contribute to postoperative pain management and are often consulted about longer-term pain problems as well. A large component of persistent pain after surgery can be defined as neuropathic pain (NP). Nerves are injured during surgery and pain can persist after the surgical wound has healed. NP is because of a primary lesion or dysfunction of the peripheral or central nervous system. Prevalence estimates indicate that 2-3% of the population in the developed world experience NP. Persistent post-surgical NP is a mostly unrecognized clinical problem. The chronicity and persistence of post-surgical NP is often severely debilitating and impinges on the psychosocial, physical, economic and emotional well-being of patients. Options for treatment of any neuropathic factors are based on understanding the pain mechanisms involved. The current understandings of the mechanisms involved are presented. There is reasonable evidence for the efficacy of pharmacological management for NP. The aim of this article was to appraise the prevention, diagnostic work-up, the physical and particularly the pharmacological management of post-surgical NP and to provide a glimpse of advances in the field. It is a practical approach to post-surgical NP for all surgeons and anaesthetists. The take-home message is that prevention is better than waiting for post-surgical NP to become persistent.

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Section: Perioperative and Multimodal Analgesiamentioning

confidence: 99%

Post‐surgical Neuropathic Pain

Shipton

2008

ANZ Journal of Surgery

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“…Arthroscopic knee surgery, a common outpatient procedure, is often associated with a degree of post‐operative pain . Pain following an arthroscopic procedure can not only affect the ability of the patient to participate in rehabilitation of their limb, but can also delay their discharge from the healthcare facility, thus resulting in an increased burden on healthcare resources, and impact on the patient's activities of daily living such as sleep, appetite and concentration levels . In an effort to reduce post‐operative pain and the repercussions associated with it, research is currently focused on refining local anaesthetic (LA) regimens, in preference to an increased reliance on systemic opioids …”

Section: Introductionmentioning

confidence: 99%

Tramadol as an adjunct to intra‐articular local anaesthetic infiltration in knee arthroscopy: a systematic review and meta‐analysis

Ryan

Hodge

Holyoak

et al. 2019

ANZ Journal of Surgery

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Background Arthroscopic knee surgery is a common technique used in Australia. Post‐operative pain is common and can lead to delayed discharge and impair early mobilization. Use of local anaesthesia can reduce pain while avoiding systemic side effects. This systematic review and meta‐analysis aimed to establish the use of tramadol as an adjunct to intra‐articular local anaesthetic infiltration in knee arthroscopy in the current literature. Methods Two independent reviewers performed a systematic search of four databases, where 24 articles were identified with six studies (four high‐quality and two low‐quality randomized controlled trials), with a total of 334 patients were included for analysis. RevMan 5.3 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used to perform the data analysis. The studies included focused on outcomes such as pain scores, breakthrough analgesia, total analgesia, time to discharge and adverse events related to the use of tramadol as an adjunctive therapy. Results This study found that using tramadol as an adjunct to intra‐articular local anaesthetic infiltration in arthroscopic knee surgery reduced post‐operative pain and increased time to breakthrough analgesia without an increase in side effects. Conclusion This meta‐analysis suggests that tramadol is an efficacious adjunct for use in intra‐articular local anaesthetic infiltration following arthroscopic knee surgery.

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“…8 In addition to providing short-term analgesic benefits, the use of pre-emptive multimodal analgesia including COX-2 inhibitors resulted in a significant reduction in long-term patellofemoral complications after ACL surgery. 9 These included a reduction in the incidence of anterior knee pain, scar tissue, flexion contracture and complex regional pain syndrome. Further, patients receiving perioperative COX-2 inhibitors were more likely to return to their pre-injury level of activity including full sports participation.…”

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confidence: 99%

“…Further, patients receiving perioperative COX-2 inhibitors were more likely to return to their pre-injury level of activity including full sports participation. 9 Sportsrelated injuries at a young age are a major cause of arthritis in patients ,40 years of age. Trials of COX-2 inhibitors used before surgery and for 2 weeks after in patients undergoing joint replacement surgery 10 have shown improved clinical outcomes.…”

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confidence: 99%