Improved Pain Management in Knee Osteoarthritis-related Surgeries
Study Details
Study Description
Brief Summary
In recent years, pain management coordinated with enhanced recovery after surgery (ERAS) has been widely applied and rapidly developed in orthopedics, showing promising prospects. Since 2016, our hospital has used a series of continuously improved pain management schemes for patients with knee OA who underwent total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), and high tibial osteotomy (HTO). Here, we retrospectively analyze these patients' clinical data to compare the effects of different pain intervention measures during the perioperative period on postoperative pain, functional exercise, hospital stay, and prognosis of the three surgical methods in an attempt to provide a feasible solution for pain management of these patients.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
We retrospectively analyzed the clinical data of patients with knee osteoarthritis (OA) who received surgical treatment to provide a feasible solution for perioperative pain management of these patients. The medical records of 714 patients with knee OA who had undergone total knee arthroplasty (n=551), unicompartmental knee arthroplasty (n=92) and high tibial osteotomy (n=71) were retrospectively analyzed and the cases were divided into Groups A, B, and C, according to the continuously optimized pain management. Clinical data including anesthesia grade, surgery time, functional exercise, hospital stay, pain, emotion, complications and prognosis were compared.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Total knee arthroplasty (TKA) Total knee arthroplasty |
Procedure: Preoperative pain managment
propaganda and education on pain; Preemptive analgesia with celecoxib (200 mg bid) 2 days before surgery
Procedure: Intraoperative pain managment
Squeeze to expel blood (tourniquet); Before skin suture, 20 mL 0.5% ropivacaine was given subcutaneously for local infiltration anesthesia;
Procedure: Postoperative pain managment
The intravenous analgesia pump was placed until 48 h after surgery;On the second day after surgery, celecoxib (200 mg bid) was administered orally, and buprenorphine transdermal patch was applied externally until hospital discharge;FNB catheter was placed under the guidance of ultrasound and connected with an analgesic pump, the anesthesia lasted until 48 h after surgery ‡
|
| Unicompartmental knee arthroplasty (UKA) Unicompartmental knee arthroplasty |
Procedure: Preoperative pain managment
propaganda and education on pain; Preemptive analgesia with celecoxib (200 mg bid) 2 days before surgery
Procedure: Intraoperative pain managment
Squeeze to expel blood (tourniquet); Before skin suture, 20 mL 0.5% ropivacaine was given subcutaneously for local infiltration anesthesia;
Procedure: Postoperative pain managment
The intravenous analgesia pump was placed until 48 h after surgery;On the second day after surgery, celecoxib (200 mg bid) was administered orally, and buprenorphine transdermal patch was applied externally until hospital discharge;FNB catheter was placed under the guidance of ultrasound and connected with an analgesic pump, the anesthesia lasted until 48 h after surgery ‡
|
| High tibial osteotomy (HTO) High tibial osteotomy |
Procedure: Preoperative pain managment
propaganda and education on pain; Preemptive analgesia with celecoxib (200 mg bid) 2 days before surgery
Procedure: Intraoperative pain managment
Squeeze to expel blood (tourniquet); Before skin suture, 20 mL 0.5% ropivacaine was given subcutaneously for local infiltration anesthesia;
Procedure: Postoperative pain managment
The intravenous analgesia pump was placed until 48 h after surgery;On the second day after surgery, celecoxib (200 mg bid) was administered orally, and buprenorphine transdermal patch was applied externally until hospital discharge;FNB catheter was placed under the guidance of ultrasound and connected with an analgesic pump, the anesthesia lasted until 48 h after surgery ‡
|
Outcome Measures
Primary Outcome Measures
- visual analogue score (VAS) [24 hours after surgery]
visual analogue score (VAS)
- visual analogue score (VAS) [72 hours after surgery]
visual analogue score (VAS)
Secondary Outcome Measures
- Quadriceps muscle strength [24 hours after surgery]
Quadriceps muscle strength
- Quadriceps muscle strength [72 hours after surgery]
Quadriceps muscle strength
- Scope of activities to knee joint [24 hours after surgery]
Scope of activities to knee joint
- Scope of activities to knee joint [72 hours after surgery]
Scope of activities to knee joint
Other Outcome Measures
- Self-Rating Anxiety Scale (SAS) [24 hours after surgery]
Self-Rating Anxiety Scale (SAS)
- Self-Rating Anxiety Scale (SAS) [72 hours after surgery]
Self-Rating Anxiety Scale (SAS)
- Self-Rating Depression Scale (SDS) [24 hours after surgery]
Self-Rating Depression Scale (SDS)
- Self-Rating Depression Scale (SDS) [72 hours after surgery]
Self-Rating Depression Scale (SDS)
Eligibility Criteria
Criteria
Inclusion Criteria:
- first knee surgery were 50-80 years old had complete clinical and follow-up data
Exclusion Criteria:
- American Society of Anesthesiologists Physical Status grade≥4 comorbidity with three or more systemic diseases long-term anxiety and depression, contraindications of painkillers, long-term alcoholism, or taking painkillers concomitant limb pain caused by spinal degeneration
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Sichuan Provincial People's Hospital | Chengdu | Sichuan | China | 610072 |
Sponsors and Collaborators
- Peng Liu
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2023-414