Periarticular multimodal drug injection is better than single anesthetic drug in controlling pain after total knee arthroplasty
Background Postoperative pain is one of the issues that concern most patients after total knee arthroplasty (TKA). Periarticular multimodal drug injection and single anesthetic agent injection have been shown to effectively reduce postoperative pain. The purpose of this study was to compare the effi...
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| Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2018-05, Vol.28 (4), p.667-675 |
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| container_title | European journal of orthopaedic surgery & traumatology |
| container_volume | 28 |
| creator | Tammachote, Nattapol Kanitnate, Supakit Manuwong, Sudsayam Panichkul, Phonthakorn |
| description | Background
Postoperative pain is one of the issues that concern most patients after total knee arthroplasty (TKA). Periarticular multimodal drug injection and single anesthetic agent injection have been shown to effectively reduce postoperative pain. The purpose of this study was to compare the efficacy between multimodal drug injection and single anesthetic drug injection in controlling pain after TKA using a double-blinded randomized controlled trial.
Methods
Sixty-four osteoarthritic patients who underwent primary TKA were randomized into two groups. The multimodal drug injection group (group M) received levobupivacaine 150 mg, ketorolac 30 mg and morphine 5 mg, while the single anesthetic drug injection group (group S) received only levobupivacaine 150 mg. The primary outcomes were pain level (VAS), quantity of opioid consumption (mg) and time to request the first dose of analgesic drug (min).
Results
Multimodal drug injection provided lower pain level in the first 4 h after surgery (VAS rest: 30 vs 46,
p
= 0.02; VAS motion: 45 vs 66,
p
= 0.03). They consumed less morphine mostly in the first 8 h after surgery (5 vs 12 mg,
p
|
| doi_str_mv | 10.1007/s00590-017-2110-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1979498294</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2351567911</sourcerecordid><originalsourceid>FETCH-LOGICAL-c313x-9afc239e1c9d61894cfed5c4e1a548106e55608e6ce02d0a900376bc0c842c283</originalsourceid><addsrcrecordid>eNp1kU2LFDEQhhtR3A_9AV4k4MVLa1XSSXeOsvixsKAHPYdMunqmx3QyJmmYPfnXzTq7CoKnCpXnfauKt2leILxBgP5tBpAaWsC-5YjQHh8159gJ3iKo4XF9KyHaAZQ8ay5y3gOg1CifNmdcc9X1gzpvfn6hNNtUZrd6m9iy-jIvcbSejWndsjnsyZU5BjZntqFSKLGys4HlOWw9MRsolx1V-QPPXAwlRe8rwA62Nuz0WxVLNf0eqIpS2aV48DaX22fNk8n6TM_v62Xz7cP7r1ef2pvPH6-v3t20TqA4ttpOjgtN6PSocNCdm2iUriO0shvquSSlgoGUI-AjWA0gerVx4IaOOz6Iy-b1yfeQ4o-1Lm2WOTvyvl4Q12xQ97rTA9ddRV_9g-7jmkLdznAhUapeI1YKT5RLMedEkzmkebHp1iCYu3TMKR1T0zF36Zhj1by8d143C41_FA9xVICfgFy_wpbS39H_d_0F0IKc9g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2351567911</pqid></control><display><type>article</type><title>Periarticular multimodal drug injection is better than single anesthetic drug in controlling pain after total knee arthroplasty</title><source>Springer Nature - Complete Springer Journals</source><creator>Tammachote, Nattapol ; Kanitnate, Supakit ; Manuwong, Sudsayam ; Panichkul, Phonthakorn</creator><creatorcontrib>Tammachote, Nattapol ; Kanitnate, Supakit ; Manuwong, Sudsayam ; Panichkul, Phonthakorn</creatorcontrib><description>Background
Postoperative pain is one of the issues that concern most patients after total knee arthroplasty (TKA). Periarticular multimodal drug injection and single anesthetic agent injection have been shown to effectively reduce postoperative pain. The purpose of this study was to compare the efficacy between multimodal drug injection and single anesthetic drug injection in controlling pain after TKA using a double-blinded randomized controlled trial.
Methods
Sixty-four osteoarthritic patients who underwent primary TKA were randomized into two groups. The multimodal drug injection group (group M) received levobupivacaine 150 mg, ketorolac 30 mg and morphine 5 mg, while the single anesthetic drug injection group (group S) received only levobupivacaine 150 mg. The primary outcomes were pain level (VAS), quantity of opioid consumption (mg) and time to request the first dose of analgesic drug (min).
Results
Multimodal drug injection provided lower pain level in the first 4 h after surgery (VAS rest: 30 vs 46,
p
= 0.02; VAS motion: 45 vs 66,
p
= 0.03). They consumed less morphine mostly in the first 8 h after surgery (5 vs 12 mg,
p
< 0.0001) and had approximately 2 h longer time to request the first dose of analgesic drug (254 vs 148 min,
p
= 0.02).
Conclusions
Multimodal drug injection decreases pain level, reduces morphine consumption in the early postoperative period and prolongs the analgesic effect compared to single anesthetic drug. One may consider using single anesthetic agent only in patients who have high risk of opioid or NSAIDs side effect.</description><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-017-2110-x</identifier><identifier>PMID: 29264786</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Analgesics ; Drug dosages ; Health risk assessment ; Joint replacement surgery ; Joint surgery ; Medicine ; Medicine & Public Health ; Narcotics ; Original Article • KNEE - ARTHROPLASTY ; Pain ; Surgical Orthopedics ; Traumatic Surgery</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2018-05, Vol.28 (4), p.667-675</ispartof><rights>Springer-Verlag France SAS, part of Springer Nature 2017</rights><rights>European Journal of Orthopaedic Surgery and Traumatology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c313x-9afc239e1c9d61894cfed5c4e1a548106e55608e6ce02d0a900376bc0c842c283</citedby><cites>FETCH-LOGICAL-c313x-9afc239e1c9d61894cfed5c4e1a548106e55608e6ce02d0a900376bc0c842c283</cites><orcidid>0000-0003-1978-3490</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00590-017-2110-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00590-017-2110-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29264786$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tammachote, Nattapol</creatorcontrib><creatorcontrib>Kanitnate, Supakit</creatorcontrib><creatorcontrib>Manuwong, Sudsayam</creatorcontrib><creatorcontrib>Panichkul, Phonthakorn</creatorcontrib><title>Periarticular multimodal drug injection is better than single anesthetic drug in controlling pain after total knee arthroplasty</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>Background
Postoperative pain is one of the issues that concern most patients after total knee arthroplasty (TKA). Periarticular multimodal drug injection and single anesthetic agent injection have been shown to effectively reduce postoperative pain. The purpose of this study was to compare the efficacy between multimodal drug injection and single anesthetic drug injection in controlling pain after TKA using a double-blinded randomized controlled trial.
Methods
Sixty-four osteoarthritic patients who underwent primary TKA were randomized into two groups. The multimodal drug injection group (group M) received levobupivacaine 150 mg, ketorolac 30 mg and morphine 5 mg, while the single anesthetic drug injection group (group S) received only levobupivacaine 150 mg. The primary outcomes were pain level (VAS), quantity of opioid consumption (mg) and time to request the first dose of analgesic drug (min).
Results
Multimodal drug injection provided lower pain level in the first 4 h after surgery (VAS rest: 30 vs 46,
p
= 0.02; VAS motion: 45 vs 66,
p
= 0.03). They consumed less morphine mostly in the first 8 h after surgery (5 vs 12 mg,
p
< 0.0001) and had approximately 2 h longer time to request the first dose of analgesic drug (254 vs 148 min,
p
= 0.02).
Conclusions
Multimodal drug injection decreases pain level, reduces morphine consumption in the early postoperative period and prolongs the analgesic effect compared to single anesthetic drug. One may consider using single anesthetic agent only in patients who have high risk of opioid or NSAIDs side effect.</description><subject>Analgesics</subject><subject>Drug dosages</subject><subject>Health risk assessment</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Narcotics</subject><subject>Original Article • KNEE - ARTHROPLASTY</subject><subject>Pain</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp1kU2LFDEQhhtR3A_9AV4k4MVLa1XSSXeOsvixsKAHPYdMunqmx3QyJmmYPfnXzTq7CoKnCpXnfauKt2leILxBgP5tBpAaWsC-5YjQHh8159gJ3iKo4XF9KyHaAZQ8ay5y3gOg1CifNmdcc9X1gzpvfn6hNNtUZrd6m9iy-jIvcbSejWndsjnsyZU5BjZntqFSKLGys4HlOWw9MRsolx1V-QPPXAwlRe8rwA62Nuz0WxVLNf0eqIpS2aV48DaX22fNk8n6TM_v62Xz7cP7r1ef2pvPH6-v3t20TqA4ttpOjgtN6PSocNCdm2iUriO0shvquSSlgoGUI-AjWA0gerVx4IaOOz6Iy-b1yfeQ4o-1Lm2WOTvyvl4Q12xQ97rTA9ddRV_9g-7jmkLdznAhUapeI1YKT5RLMedEkzmkebHp1iCYu3TMKR1T0zF36Zhj1by8d143C41_FA9xVICfgFy_wpbS39H_d_0F0IKc9g</recordid><startdate>20180501</startdate><enddate>20180501</enddate><creator>Tammachote, Nattapol</creator><creator>Kanitnate, Supakit</creator><creator>Manuwong, Sudsayam</creator><creator>Panichkul, Phonthakorn</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1978-3490</orcidid></search><sort><creationdate>20180501</creationdate><title>Periarticular multimodal drug injection is better than single anesthetic drug in controlling pain after total knee arthroplasty</title><author>Tammachote, Nattapol ; Kanitnate, Supakit ; Manuwong, Sudsayam ; Panichkul, Phonthakorn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313x-9afc239e1c9d61894cfed5c4e1a548106e55608e6ce02d0a900376bc0c842c283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Analgesics</topic><topic>Drug dosages</topic><topic>Health risk assessment</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Narcotics</topic><topic>Original Article • KNEE - ARTHROPLASTY</topic><topic>Pain</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tammachote, Nattapol</creatorcontrib><creatorcontrib>Kanitnate, Supakit</creatorcontrib><creatorcontrib>Manuwong, Sudsayam</creatorcontrib><creatorcontrib>Panichkul, Phonthakorn</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tammachote, Nattapol</au><au>Kanitnate, Supakit</au><au>Manuwong, Sudsayam</au><au>Panichkul, Phonthakorn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Periarticular multimodal drug injection is better than single anesthetic drug in controlling pain after total knee arthroplasty</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><date>2018-05-01</date><risdate>2018</risdate><volume>28</volume><issue>4</issue><spage>667</spage><epage>675</epage><pages>667-675</pages><issn>1633-8065</issn><eissn>1432-1068</eissn><abstract>Background
Postoperative pain is one of the issues that concern most patients after total knee arthroplasty (TKA). Periarticular multimodal drug injection and single anesthetic agent injection have been shown to effectively reduce postoperative pain. The purpose of this study was to compare the efficacy between multimodal drug injection and single anesthetic drug injection in controlling pain after TKA using a double-blinded randomized controlled trial.
Methods
Sixty-four osteoarthritic patients who underwent primary TKA were randomized into two groups. The multimodal drug injection group (group M) received levobupivacaine 150 mg, ketorolac 30 mg and morphine 5 mg, while the single anesthetic drug injection group (group S) received only levobupivacaine 150 mg. The primary outcomes were pain level (VAS), quantity of opioid consumption (mg) and time to request the first dose of analgesic drug (min).
Results
Multimodal drug injection provided lower pain level in the first 4 h after surgery (VAS rest: 30 vs 46,
p
= 0.02; VAS motion: 45 vs 66,
p
= 0.03). They consumed less morphine mostly in the first 8 h after surgery (5 vs 12 mg,
p
< 0.0001) and had approximately 2 h longer time to request the first dose of analgesic drug (254 vs 148 min,
p
= 0.02).
Conclusions
Multimodal drug injection decreases pain level, reduces morphine consumption in the early postoperative period and prolongs the analgesic effect compared to single anesthetic drug. One may consider using single anesthetic agent only in patients who have high risk of opioid or NSAIDs side effect.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>29264786</pmid><doi>10.1007/s00590-017-2110-x</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1978-3490</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Analgesics Drug dosages Health risk assessment Joint replacement surgery Joint surgery Medicine Medicine & Public Health Narcotics Original Article • KNEE - ARTHROPLASTY Pain Surgical Orthopedics Traumatic Surgery |
| title | Periarticular multimodal drug injection is better than single anesthetic drug in controlling pain after total knee arthroplasty |
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