title: Comparison of Two Multimodal Pain Regimens Used for Postoperative Pain Control in Total Joint Arthroplasty Patients.
abstract: Postoperative pain control following total joint arthroplasty results in improved patient mobilization, participation in physical therapy, and potentially reduced hospital costs. It was hypothesized that using a multimodal pain protocol focusing on periarticular injections including liposomal bupivacaine would have improved results when compared with a parenteral opioid-based regimen. The results showed a decrease in length of stay and rate of discharge to skilled nursing facilities with the implementation of a novel multimodal pain protocol. Furthermore, there was no change in patient satisfaction before and after the execution of the new protocol. It was concluded that using a multimodal pain protocol based on periarticular injections can lead to decreased length of stay and a decrease in transfer to skilled nursing facilities without a change in patient satisfaction.
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Jinnah
authors.forename: Beth P
authors.initials: BP
authors.lastname: Smith
authors.forename: Brett C
authors.initials: BC
authors.lastname: Perricelli
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000284:Administration, Oral; D016058:Analgesia, Patient-Controlled / Q000379:methods; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage*; D000068579:Celecoxib / Q000627:therapeutic use; D002985:Clinical Protocols; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008081:Liposomes; D009407:Nerve Block / Q000379:methods; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D017060:Patient Satisfaction; D012189:Retrospective Studies
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D052246:Cyclooxygenase 2 Inhibitors; D008081:Liposomes; D000082:Acetaminophen; D000068579:Celecoxib; D002045:Bupivacaine