A prospective evaluation of 2 different pain management protocols for total hip arthroplasty.
Pain management after total hip arthroplasty has improved dramatically in the past decade. However, most protocols use opioid medications for pain control. In the current study, 100 patients were prospectively selected to receive a traditional narcotic-based patient-controlled analgesia protocol or a nonnarcotic oral protocol for pain management after primary total hip arthroplasty. Therapy programs were similar for both groups. Postoperatively, patients were followed daily for opioid use, medication adverse effects, pain control, and overall satisfaction. The nonnarcotic oral group showed lower mean pain scores during the first 24 hours after surgery. The satisfaction rate was high in both groups. Both protocols provided adequate pain control after total hip arthroplasty; the nonnarcotic pain management protocol resulted in significantly decreased opioid consumption and fewer adverse effects.
Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Zachary D
ZD
Post
Camilo
C
Restrepo
Lauren K
LK
Kahl
Tim
T
van de Leur
James J
JJ
Purtill
William J
WJ
Hozack
D000082:Acetaminophen / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D000068579:Celecoxib; D011431:Dextropropoxyphene / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000009:adverse effects / Q000627:therapeutic use; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use*; D010098:Oxycodone / Q000009:adverse effects / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D017060:Patient Satisfaction; D000069583:Pregabalin; D011446:Prospective Studies; D011720:Pyrazoles / Q000009:adverse effects / Q000627:therapeutic use; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
D018712:Analgesics, Non-Narcotic; D009294:Narcotics; D011720:Pyrazoles; D013449:Sulfonamides; D000082:Acetaminophen; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D010098:Oxycodone; D000068579:Celecoxib; D011431:Dextropropoxyphene; D005283:Fentanyl