Title

The Challenges of Perioperative Pain Management in Total Joint Arthroplasty

Publication Date

2015

Journal Title

Am J Orthop (Belle Mead NJ)

Abstract

Despite advances in the understanding of postoperative pain, approximately 80% of surgical patients still experience a meaningful level of pain, which can result in unnecessary stress and suffering; compromise the patient's progress, recovery, and outcome; and lead to poor function and the development of chronic pain. In arthroplasty patients, the goals of pain management include improving comfort and satisfaction, enabling patients to ambulate and move their joints soon after surgery, and, where appropriate, reducing the hospital length of stay. Opioid medications have been used for many years as the mainstay of pain management. These drugs, however, are associated with a range of adverse effects and complications, which can lead to increased hospital length of stay or readmission. Furthermore, as-needed administration of opioids allows for the repeated return of pain after the operation as each dose wears off. A balanced multimodal approach that combines different anesthetic and analgesic modalities in a rational way to target the distinct pain pathways, rather than relying predominantly on opioid drugs, is essential for effective control of postoperative pain, avoiding the risk of opioid-related adverse events and complications, reducing length of stay, and improving longterm outcomes.

Volume Number

44

Issue Number

10 Suppl

Pages

S2-4

Document Type

Article

EPub Date

2015/10/09

Status

Faculty

Facility

School of Medicine

Primary Department

Orthopedic Surgery

PMID

26447428