title: Pain management protocols, peri-operative pain and patient satisfaction after total knee replacement: a multicentre study.
abstract: In a prospective multicentre study we investigated   variations in pain management used by knee arthroplasty surgeons   in order to compare the differences in pain levels among patients   undergoing total knee replacements (TKR), and to compare the effectiveness   of pain management protocols. The protocols, peri-operative levels   of pain and patient satisfaction were investigated in 424 patients   who underwent TKR in 14 hospitals. The protocols were highly variable   and peri-operative pain levels varied substantially, particularly   during the first two post-operative days. Differences in levels   of pain were greatest during the night after TKR, when visual analogue   scores ranged from 16.9 to 94.3 points. Of the methods of managing pain, the combined use of peri-articular   infiltration and nerve blocks provided better pain relief than other   methods during the first two post-operative days. Patients managed   with peri-articular injection plus nerve block, and epidural analgesia   were more likely to have higher satisfaction at two weeks after TKR.   This study highlights the need to establish a consistent pain management   strategy after TKR.
authors.affiliation: Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.
authors.forename: C B
authors.initials: CB
authors.lastname: Chang
authors.forename: W S
authors.initials: WS
authors.lastname: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D017060:Patient Satisfaction; D059035:Perioperative Period; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome