Clin Orthop Surg.  2009 Sep;1(3):155-160. 10.4055/cios.2009.1.3.155.

Efficacy of Multimodal Pain Control Protocol in the Setting of Total Hip Arthroplasty

• Lee KJ
• Min BW
• Bae KC
• Cho CH
• Kwon DH

• KMID: 999394
• DOI: http://doi.org/10.4055/cios.2009.1.3.155

Abstract

BACKGROUND
This study evaluated the benefits and safety of a multimodal pain control protocol, which included a periarticular injection of local anesthetics, in patients undergoing total hip arthroplasty. METHODS: Between March 2006 and March 2007, 60 patients undergoing unilateral total hip arthroplasty were randomized to undergo either a multimodal pain control protocol or a conventional pain control protocol. The following parameters were compared: the preoperative and postoperative visual analogue scales (VAS), hospital stay, operative time, postoperative rehabilitation, additional painkiller consumption, and complication rates. RESULTS: There was no difference between the groups in terms of diagnosis, age, gender, and BMI. Although both groups had similar VAS scores in the preoperative period and on the fifth postoperative day, there was a significant difference between the groups over the four-day period after surgery. There were no differences in the hospital stay, operative time, additional painkiller consumption, or complication rate between the groups. The average time for comfortable crutch ambulation was 2.8 days in the multimodal pain control protocol group and 5.3 days in the control group. CONCLUSIONS: The multimodal pain control protocol can significantly reduce the level of postoperative pain and improve patients' satisfaction, with no apparent risks, after total hip arthroplasty.

Keyword

Total hip arthroplasty; Multimodal pain control protocol; Visual analogue scale

MeSH Terms

Adult
Aged
Amides/administration & dosage
Analgesia/*methods
*Arthroplasty, Replacement, Hip
Clinical Protocols
Female
Humans
Injections, Intra-Articular
Length of Stay
Male
Methylprednisolone/administration & dosage
Middle Aged
Morphine/administration & dosage
Narcotics/administration & dosage
Pain/prevention & control
Pain Measurement
Pain, Postoperative/prevention & control

Figure

• 

  Fig. 1 Summary of the visual analogue scale (VAS) for pain. Imm. PO: Immediate postoperatively, POD1, POD2, POD3, POD4, and POD5: one, two, three, four, and five days postoperatively.

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