scholarly journals Comparison of 2 Peripheral Nerve Blocks Techniques for Functional Recovery and Postoperative Pain Management After Total Knee Arthroplasty: A Prospective, Double-Blinded, Randomized Trial

2021 ◽  
Vol 27 ◽  
Author(s):  
Inna Jaremko ◽  
Karina Lukaševič ◽  
Šarūnas Tarasevičius ◽  
Linas Zeniauskas ◽  
Andrius Macas ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Postoperative Pain ◽  
Peripheral Nerve ◽  
Knee Arthroplasty ◽  
Postoperative Pain Management ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Total Knee ◽  
Double Blinded

Reducing opioid usage in total knee arthroplasty postoperative pain management: a literature review and future directions

2021 ◽  
Author(s):  
Rahul Chaturvedi ◽  
Jennifer Tram ◽  
Krishnan Chakravarthy
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Postoperative Pain ◽  
Literature Review ◽  
Knee Arthroplasty ◽  
Postoperative Pain Management ◽  
Functional Mobility ◽  
Local Infiltration Analgesia ◽  
Nerve Blocks ◽  
Total Knee

Total knee arthroplasty (TKA) is a common orthopedic surgery performed with a projected 3.5 million procedures to be done by 2030. Current postoperative pain management for TKA is insufficient, as it results in extensive opioid consumption and functional decline postoperatively. This study identifies the best practices for postoperative TKA pain management through a literature review of the last three years. Studies utilizing interventional techniques (local infiltration analgesia, nerve blocks) and pharmacologic options were reviewed on PubMed, Embase, Ovid Medline and Scopus. Primary outcomes analyzed were the effect of different analgesic approaches on pain reduction, opioid use reduction and improvements in functional mobility or quadriceps strength postoperatively. Additionally, this paper explores the use of cooled radiofrequency ablation, a minimally invasive therapy, for preoperative and postoperative TKA pain management.

Pain Control in Total Knee Arthroplasty

2017 ◽  
Vol 31 (06) ◽  
pp. 504-513 ◽  
Author(s):  
Randa Elmallah ◽  
Morad Chughtai ◽  
Anton Khlopas ◽  
Jared Newman ◽  
Kim Stearns ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Peripheral Nerve ◽  
Knee Arthroplasty ◽  
Local Anesthetics ◽  
Current Evidence ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Delayed Release ◽  
Total Knee

AbstractAs surgical techniques and pharmacology advance, the management of postoperative pain in patients undergoing total knee arthroplasty (TKA) continues to evolve. The current standards of care are composed of multimodal pain management including opioids, nonsteroidal anti-inflammatory drugs and gabapentinoids, peripheral nerve blocks, and periarticular injections. Newer modalities are composed of delayed release local anesthetics and cryoneurolysis. To summarize the current evidence-based treatment modalities and forecast changes in the management of patients having TKAs, we reviewed available data on: (1) oral analgesics; (2) periarticular injections; (3) peripheral nerve blocks; (4) multimodal regimens; and (5) newer modalities in post-TKA pain management. Multimodal analgesic regimens that target numerous pain pathways may provide the best pain management, rehabilitation, patient satisfaction, and reduce opioid use and related side effects. Periarticular injections of delayed-release local anesthetics may further enhance pain management.

scholarly journals Evidence-based Review of Periarticular Injections and Peripheral Nerve Blocks in Total Knee Arthroplasty

2020 ◽  
Vol 14 (1) ◽  
pp. 69-72
Author(s):  
Alexander Gaukhman ◽  
Simon Garceau ◽  
Ran Schwarzkopf ◽  
James Slover
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Knee Arthroplasty ◽  
Motor Blockade ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Post Operative Pain ◽  
Total Knee

Background: Recently, post-operative pain management after Total Knee Arthroplasty (TKA) has focused on a multimodal approach for reducing opioid requirements, promoting early rehabilitation, and expediting discharge from hospital. Regional anesthesia, in the form of Periarticular Injections (PAI) and Peripheral Nerve Blocks (PNB), has shown promise as adjunctive therapy to oral analgesics. Objective: To review the current literature surrounding regional anesthesia for TKA. Discussion: PNBs provide effective analgesia after TKA. Historically, femoral nerve blocks (FNB) have been commonly employed. FNBs, however, lead to the significant motor blockade to the quadriceps musculature, which can dampen early rehabilitation efforts and increase the risk of post-operative falls. Adductor Canal Blocks (ACB) have shown excellent results in reducing post-operative pain while minimizing motor blockade. Periarticular injections (PAI), and infiltration between the popliteal Artery and Capsule of the Knee (IPACK) have similarly helped in reducing patient discomfort after TKA and providing analgesia to the posterior capsular region of the knee. Conclusion: PAIs, and PNBs are important elements in many multimodal postoperative pain management protocols after TKA. Current evidence appears to suggest that a combination of an ACB supplemented by posterior capsular analgesic coverage through PAI or IPACK may provide optimal results.

scholarly journals The efficacy of pre-emptive analgesia on pain management in total knee arthroplasty: a mini-review

Arthroplasty ◽  
2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Jianda Xu ◽  
Huan Li ◽  
Chong Zheng ◽  
Bin Wang ◽  
Pengfei Shen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Physiological Mechanism ◽  
Cost Effective ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Total Knee ◽  
End Stage

Abstract Total knee arthroplasty (TKA) is considered a cost-effective and efficacious treatment for patients with end-stage knee arthritis. Meanwhile, TKA has been regarded as one of the most painful orthopaedic surgeries. Pain control after TKA remains a challenging task. Many analgesic innovations are used to reduce the level of pain, but none has been proven to be the optimum choice till now. Multimodal analgesia incorporates the use of analgesic adjuncts with different mechanisms of action to enhance postoperative pain management. This approach is a preferable choice in relieving postoperative pain with minimum side effects. This paper aims to review pre-emptive analgesia for pain management in TKA. We reviewed the application of pre-emptive analgesia, its physiological mechanism, and the techniques.

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