Pain management

Abstract

Many patients experience severe pain after total knee arthroplasty (TKA) which can lead to several pathophysiological responses, increasing morbidity and delaying prompt rehabilitation. Analgesic regimens, based on a multimodal approach including preemptive NSAIDs and opioids, neuraxial or regional peripheral nerve blockade, and patient-controlled opioid infusions, not only provide effective pain relief and high patient satisfaction but also result in improved functionality, decreased recovery time, and shortened hospital stay. Though epidural techniques provide the best results, use of this method is limited by increased risk of serious complications due to combination with thromboembolism prophylaxis, and femoral three-in-one or lumbar plexus blocks may be preferable. © 2005 Springer Medizin Verlag Heidelberg.