In-Hospital Pain and Opioid Consumption After Primary Total Knee Arthroplasty Compared to Primary Total Hip Arthroplasty: Results from 7330 Patients Treated in a Fast-Track Setting.

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2025-03-14 DOI:10.1007/s40122-025-00716-8

Janne Kristin Hofstad, Tina Strømdal Wik, Pål Klepstad, Kari Hanne Gjeilo, Siri Bjørgen Winther, Olav A Foss

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引用次数: 0

Abstract

Introduction: Differences in in-hospital pain and consumption of opioids after primary total hip arthroplasty (THA) and knee arthroplasty (TKA) have been rarely studied in a setting where the patient course is otherwise similar. The aim of this study was to compare early pain intensity and opioid usage between patients who have undergone THA and TKA to identify potential implications for outpatient surgery.

Methods: This institutional register study included 4655 patients receiving THA and 2675 patients receiving TKA. Pain at rest and during mobilization were collected once preoperatively, and postoperatively at five time-points, twice on the Day of surgery, once each on day 1 and day 2 after surgery, and at discharge, on a numeric rating scale (NRS) 0-10. Rescue opioids in oral morphine-equivalent doses (MME) were consecutively registered. Postoperative mobilization was registered twice daily.

Results: Overall mean pain were 2.0 (Cl 2.0-2.0) after THA and 2.3 (Cl 2.3-2.4) after TKA at rest, and 3.3 (Cl 3.3-3.3) and 3.7 (Cl 3.7-3.8) during mobilization, respectively. Patients undergoing TKA had a transient increase in pain intensity the day after surgery, whereas patients undergoing THA had improved pain levels. Outpatient criteria for pain (NRS < 5 during mobilization) were feasible for 37% of THA and 35% of TKA. Total median MME was 30.0 (0-573) after THA and 52.5 (0-390) after TKA. Patients undergoing TKA were less mobilized during hospitalization.

Conclusion: A comparable number of THA and TKA cases were eligible for same-day discharge based on outpatient discharge criteria for pain. Patients receiving TKA can expect an increase in pain intensity and opioid needs on the day after surgery.

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与初次全髋关节置换术相比，初次全膝关节置换术后的住院疼痛和阿片类药物消耗：来自7330名在快速通道治疗的患者的结果

引言：在患者病程相似的情况下，很少研究原发性全髋关节置换术（THA）和膝关节置换术（TKA）术后住院疼痛和阿片类药物消耗的差异。本研究的目的是比较THA和TKA患者的早期疼痛强度和阿片类药物使用情况，以确定门诊手术的潜在影响。方法：本研究纳入4655例THA患者和2675例TKA患者。术前1次，术后5个时间点采集静息和活动时疼痛，手术当天2次，术后第1天和第2天各1次，出院时采集数值评定量表（NRS） 0-10。连续登记口服吗啡等效剂量（MME）的救援阿片类药物。术后活动记录每天2次。结果：全髋关节置换术后整体平均疼痛2.0 (Cl 2.0-2.0)，静息时全髋关节置换术后疼痛2.3 (Cl 2.3-2.4)，活动时疼痛3.3 （Cl 3.3-3.3）和3.7 （Cl 3.7-3.8）。接受TKA的患者在手术后一天疼痛强度短暂增加，而接受THA的患者疼痛水平有所改善。结论：根据疼痛门诊出院标准，相当数量的THA和TKA病例符合当日出院条件。接受TKA的患者在术后一天疼痛强度和阿片类药物需求会增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.