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The Archives of Bone and Joint Surgery، جلد ۶، شماره ۳، صفحات ۰-۰
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عنوان انگلیسی Multimodal Pain Management Protocol Versus Patient Controlled Narcotic Analgesia for Postoperative Pain Control after Shoulder Arthroplasty
چکیده انگلیسی مقاله Background The purpose of this study was to determine whether implementing a protocol (TLC), that utilizes a multimodal pain control approach, improves pain control and decreases narcotic utilization. Materials and Methods: Patients undergoing primary total or reverse shoulder arthroplasty using interscalene brachial plexus blockade were retrospectively studied. Patients were either provided a patient-controlled analgesic pump postoperatively ("traditional" approach) or preoperative and postoperative multimodal, non-narcotic analgesic medications and breakthrough narcotics. Morphine equivalent units (MEU) consumed and Visual Analog Scale (VAS) scores for pain (0, 8, 16, and 24 hours) were analyzed. Results: There were 108 patients in each group. In the first 24 postoperative hours, narcotic consumption was 38.5 +/- 81.1 MEU in the "Traditional group" and 59.3 +/- 59.1 MEU in the TLC group (p < 0.001). VAS pain was significantly higher in the "Traditional group" at 16 hours (4.1 +/- 2.9 vs 3.2 +/- 2.7, p = 0.020) and 24 hours (4.8 +/- 2.7 vs 3.7 +/- 2.6, p = 0.004). Discussion: While the TLC protocol led to an improved pain experience, both groups experienced rebound pain. Further modification of the current protocol may be necessary to reduce overall narcotic utilization.
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نویسندگان مقاله | Surena Namdari
Rothman Institute- Thomas Jefferson University, Department of Orthopaedic Surgery


| Thema Nicholson
Rothman Institute- Thomas Jefferson University, Department of Orthopaedic Surgery


| Mitchell Maltenfort
Rothman Institute- Thomas Jefferson University, Department of Orthopaedic Surgery


| Charles Getz
Rothman Institute- Thomas Jefferson University, Department of Orthopaedic Surgery


| Mark Lazarus
Rothman Institute- Thomas Jefferson University, Department of Orthopaedic Surgery


| Gerald Williams Jr
Rothman Institute- Thomas Jefferson University, Department of Orthopaedic Surgery
نشانی اینترنتی http://abjs.mums.ac.ir/article_10296.html
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زبان مقاله منتشر شده en
موضوعات مقاله منتشر شده
نوع مقاله منتشر شده RESEARCH PAPER
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