title: A pilot study of pain management during rehabilitation for hip and knee arthroplasty.
abstract: {\it
  
  
  OBJECTIVE
  } To evaluate the efficacy of pain management in a clinical pathway for rehabilitation after hip and knee arthroplasty, in which scheduled medications are rapidly tapered and prn medications are continued throughout the inpatient stay. {\it
  
  
  METHODS
  } A prospective cross-sectional study. {\it
  
  
  METHODS
  } General rehabilitation unit of a regional acute rehabilitation center. {\it
  
  
  METHODS
  } Twenty-nine patients admitted consecutively to the rehabilitation unit in three months. {\it
  
  
  METHODS
  } Number of pills/day of prn pain medication, pain scores at admission and discharge, frequency of constipation and nausea, Functional Independence Measure (FIM) gain, and length of stay (LOS). {\it
  
  
  RESULTS
  } For all patients, prn pain medication use was 2.4 pills/day/patient; the mean FIM gain was 22.1; and the average LOS was 9.8 days. In comparison to the Vicodin group, patients on Darvocet N-100 had significantly fewer requests for prn pain medication each day (3.1 vs. 1.1, p < 0.01), significantly better FIM gains better (18.9 vs. 24.1, p < 0.05), and fewer side effects (nausea and constipation). {\it
  
  
  CONCLUSIONS
  } Choosing the right pain medication is imperative for achieving optimal efficiency in clinical pathways for orthopedic rehabilitation. In this pilot study, Darvocet N-100 is the preferred narcotic over codeine and its derivatives.
authors.affiliation: Southern New England Rehabilitation Center, Providence, RI 02907, USA.
authors.forename: J
authors.initials: J
authors.lastname: Mukand
authors.forename: C
authors.initials: C
authors.lastname: Cai
authors.forename: C
authors.initials: C
authors.lastname: Fitzsimmons
authors.forename: T
authors.initials: T
authors.lastname: McKenna
authors.forename: A
authors.initials: A
authors.lastname: Zielinski