دورية أكاديمية
Preemptive Analgesia With Oxycodone Is Associated With More Pain Following Total Joint Arthroplasty.
| العنوان: | Preemptive Analgesia With Oxycodone Is Associated With More Pain Following Total Joint Arthroplasty. |
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| المؤلفون: | Cooper HJ; Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY., Lakra A; Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY., Maniker RB; Department of Anesthesiology, Columbia University Medical Center, New York, NY., Hickernell TR; Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY., Shah RP; Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY., Geller JA; Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY. |
| المصدر: | The Journal of arthroplasty [J Arthroplasty] 2019 Dec; Vol. 34 (12), pp. 2878-2883. Date of Electronic Publication: 2019 Jul 23. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New Brunswick, NJ : Taylor and Francis Original Publication: [New York, NY : Churchill Livingstone, c1986- |
| مواضيع طبية MeSH: | Analgesia* , Oxycodone*/therapeutic use, Analgesics, Opioid/therapeutic use ; Humans ; Pain Measurement ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Retrospective Studies |
| مستخلص: | Background: Preemptive multimodal analgesia (PMA) is a commonly used technique to control pain following total joint arthroplasty. PMA protocols use multiple analgesics immediately preoperatively to prevent central sensitization and amplification of pain during surgery. While benefits of some individual components of a PMA protocol have been established, there are little data to support inclusion or exclusion of opioids in this context. Methods: This is a retrospective cohort study of 550 patients undergoing elective, primary total joint arthroplasty at a single institution using a standardized preoperative perioperative protocol. Two hundred seventy-five patients received oxycodone in addition to a standard multimodal preoperative analgesia regimen just before surgery and were compared to a matched cohort of 275 patients who received the standard regimen alone. Outcome measures included inpatient visual analog scale pain scores, inpatient opioid consumption, length of stay, and ambulation distance with physical therapy. Results: Patients who received opioids in preoperative holding reported significantly greater visual analog scale pain scores on postoperative day 1 (3.7 vs 3.1; P = .01), when compared to those who did not. These patients also walked shorter distances on postoperative day 0 (59.5' vs 125.7'; P < .001) and consumed greater morphine equivalents per hospital day over the course of their hospital stay (52.2 vs 37.2 mg; P < .001). These differences remained significant when stratified by procedure, total knee arthroplasty or total hip arthroplasty. Differences in pain and function between groups were more pronounced in patients undergoing total hip arthroplasty than those undergoing total knee arthroplasty. Conclusion: Total joint patients who were given preemptive opioids immediately before surgery experienced more pain, consumed more postoperative opioids, and exhibited impaired early function as compared to those who were not given preemptive opioids. Orthopedic surgeons should reconsider routine use of preemptive opioids in this context. (Copyright © 2019 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: opioid-induced hyperalgesia; oxycodone; pain; preemptive analgesia; total hip arthroplasty; total knee arthroplasty |
| المشرفين على المادة: | 0 (Analgesics, Opioid) CD35PMG570 (Oxycodone) |
| تواريخ الأحداث: | Date Created: 20190813 Date Completed: 20201120 Latest Revision: 20201120 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.arth.2019.07.021 |
| PMID: | 31402074 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-8406 |
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| DOI: | 10.1016/j.arth.2019.07.021 |