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ORIGINAL ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 4  |  Page : 555-560

Retrospective analysis of pain relief in total knee replacement surgeries


1 Department of Anaesthesiology, LTMMC and LTMG Hospital, Mumbai, Maharashtra, India
2 Department of Anaesthesiology, GSMC and KEMH, Mumbai, Maharashtra, India
3 Department of Orthopaedics, LTMMC and LTMG Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Shruti Shrikant Patil
Department of Anaesthesia, 4th Floor College Building, LTMMC and LTMGH, Sion, Mumbai - 400 022, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aer.AER_117_20

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Background and Aims: The aim of the study is to measure the postoperative adequacy of pain relief and functional recovery after unilateral primary total knee arthroplasty or total knee replacement (TKR) with a multimodal approach. Settings and Design: This was a retrospective observational study done in a tertiary care center. Materials and Methods: Eighty patients aged 18–65 years (yrs) with ASA Physical Status Classes I, II, and III operated for unilateral primary TKR surgery under suitable Anaesthesia and was administered ultrasound-guided adductor canal block + periarticular infiltration (PI) from January 2018 to January 2019 were included. Thereafter, the patients visual analog scale (VAS) scores at rest, 45° knee flexion, and mobilization as well as additional analgesia given were noted after going through the records at following time points: 12 hourly for 24 h and thereafter on postoperative day 1 (POD1) and POD2. Level of block, adverse events, and functional recovery (time up and go [TUG] test, 10 s walk test) on POD1 and POD2 were also noted. Statistical Analysis and Results: The statistical software namely SPSS 18.0 were used for the analysis of the data. The mean VAS score at 12 h was 4.33 ± 1.3 which worsened at 24 h with steady improvement over the next 2 days. Similarly, the case with a mean VAS score at 45° flexion and on mobilization showed a similar trend. At 12 h postadductor block, besides intravenous (i.v.) paracetamol, 32.6% of patients were given tramadol 50 mg i.v. whereas one patient was given a buprenorphine patch in addition to tramadol. The number of patients requiring additional tramadol and buprenorphine patch steadily increased over the next 2 days. The average time taken for the TUG test at 24 h was 30.98 ± 4.77 s, and the average time taken for the 10 s walk test at 24 h was 6.16 ± 1.10 steps with improvement in performance over the next 2 days. Conclusion: In our study, our multimodal analgesia model did not provide satisfactory analgesia though mobilization was not hampered.


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