Pain Management after Total Knee Arthroplasty: Our Short-Medium Term Results

Abstract

Objective: Since knee pain causes serious morbidity after total knee arthroplasty, different techniques are applied in pain management. In this study, it was aimed to evaluate the clinical opioid needs, functional results and patient satisfaction of the patients with the Ranawat cocktail that we applied intraoperatively.
Materials and Methods: 310 patients who underwent total knee arthroplasty were included in the study. Ranawat cocktail injection containing two parts, deep and superficial, was applied to all patients. The patients' VAS scores (preoperative, postoperative 12, 24, 48th hours), opioid needs, and patient satisfaction scale were evaluated for satisfaction.
Results: The mean age was found to be 64.4±16.4 years. The mean preoperative VAS value was 7.1±1.9 the mean at the postoperative 12th hour was 5.2±2.8 the mean at the postoperative 24th hour was 3.7±2.3 and the mean at the postoperative 48th hour was 2.4±1.4. 68.3% (212 patients) of the cases were very satisfied, 31.62% (98 patients) were less satisfied. The postoperative opioid requirement was found to be 23.5%.
Conclusion: Multifocal cocktail injection is a simple, safe and effective postoperative analgesia control discipline to facilitate rehabilitation in patients who have undergone total knee arthroplasty.

Keywords

• Periarticular injection
• ranawat cocktail
• total knee arthroplasty

Total Diz Artroplastisi Sonrası Ağrı Yönetimi: Kısa-Orta Dönem Sonuçlarımız

Öz

Amaç: Total diz artroplasti sonrası diz ağrısı ciddi morbidite oluşturduğu için ağrı yönetiminde farklı teknikler uygulanmaktadır. Bu çalışmada intraoperatif uyguladığımız Ranawat kokteyli ile hastaların klinik olarak opioid ihtiyaçları, fonksiyonel sonuçları ve hasta memnuniyetinin değerlendirilmesi amaçlanmıştır.
Materyal ve Metot: Çalışmaya total diz artroplastisi uygulanan 310 hasta dahil edildi. Tüm hastalara derin ve yüzeyel olmak üzere iki kısım içeren Ranawat kokteyl enjeksiyonu uygulandı. Hastaların VAS skorları (preoperatif, postoperatif 12, 24, 48. saat), opioid ihtiyaçları ve hasta memnuniyet ölçeği ile memnuniyet değerlendirilmesi yapıldı.
Bulgular: Ortalama yaş 64,4±16,4 olarak bulundu. Preoperatif preop VAS değer ortalaması 7,1±1,9, postoperatif 12. saatteki ortalaması 5,2±2,8, postoperatif 24. saatteki ortalaması 3,7±2,3 ve postoperatif 48. saatteki ortalaması 2,4±1,4 olarak bulundu. Olguların %68,3’ü (212 hasta) çok memnun, %31,62’si (98 hasta) az memnun idi. Ameliyat sonrası opioid ihtiyacı %23,5 olarak bulundu.
Sonuç: Multiodak kokteyl enjeksiyonu total diz artroplastisi uygulanmış olan hastalarda rehabilitasyonu kolaylaştırmak açısından basit, güvenli ve etkili bir postoperatif analjezi kontrol disiplinidir.  

Anahtar Kelimeler

• Periartiküler enjeksiyon
• ranawat kokteyl
• total diz artroplastisi

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