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Anaesthesia


Title:Subacute pain and function after fast-track hip and knee arthroplasty
Author(s):Andersen, L. O. Gaarn-Larsen, L. Kristensen, B. B. Husted, H. Otte, K. S. Kehlet, H.
Address:Department of Anaesthesiology, Hvidovre University Hospital, Denmark. lasse.oestergaard.andersen@hvh.regionh.dk
Year:2009 May
Journal Title:Anaesthesia
Page Number:508-13
Language:eng
Volume:64
Issue:5
ISSN/ISBN:1365-2044 (Electronic). 0003-2409 (Linking)
Abstract:In a well-defined fast-track setup for total hip and knee arthroplasty, with a multimodal analgesic regimen consisting of intra-operative local anaesthetic infiltration and oral celecoxib, gabapentin and paracetamol for 6 days postoperatively, we conducted a prospective, consecutive, observational study. The purpose was to describe the prevalence and intensity of subacute postoperative pain and opioid related side effects, use of analgesics and functional ability 1-10 and 30 days postoperatively. Fast-track total hip and knee arthroplasty with early discharge (< 3 days) resulted in acceptable levels of pain and postoperative nausea and vomiting with concomitant low use of opioids in > 95% of patients after discharge before day 10 after total hip arthroplasty. However, after total knee arthroplasty 52% patients reported moderate pain (VAS 30-59 mm), and 16% severe pain (VAS > or = 60 mm) when walking 1 month after surgery with a concomitant increase in the use of strong opioids. These results emphasise the need for improvement in analgesia after discharge following total knee arthroplasty, to facilitate rehabilitation.

 
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