Effectiveness of Multimodal Pain Management Protocol in Total Knee Arthroplasty Patients

BACKGROUND: 

Numerous methods for postoperative pain management after total knee arthroplasty (TKA) are reported. Multimodal pain management approaches, including peripheral nerve blocks and systemic analgesia, have been shown to decrease patient pain, increase patient satisfaction with pain control, decrease length of stay (LOS), and improve patient outcomes.

PURPOSE/METHODS: 

To compare patient outcomes (pain scores, LOS, postoperative nausea and vomiting, and movement) between 66 TKA patients of a single orthopaedic surgeon in 2010 who received a multimodal approach to 45 historical (control) patients in 2009 who did not receive a multimodal pain management protocol.

RESULTS: 

Patients who were treated with the multimodal pain protocol had significantly lower pain scores in the immediate postoperative period, less postoperative nausea and vomiting day of surgery, and a decrease in LOS by half a day despite increased buckling and increased level of assistance with ambulation.

CONCLUSION: 

The multimodal pain approach improved patient outcomes in TKA patients.