ArticleThe archives of bone and joint surgery2018
Multimodal Pain Management Protocol Versus Patient Controlled Narcotic Analgesia for Postoperative Pain Control after Shoulder Arthroplasty.
Article in The archives of bone and joint surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Analgesic comparison between perineural and intravenous dexamethasone for shoulder arthroscopy: a meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2022Pooled it
- A Multimodal Pain Management Regimen for Open Treatment of Distal Radius Fractures: A Randomized Blinded Study.Hand (New York, N.Y.) · 2022Trial
- Pre-operative narcotic use is associated with worse outcomes following primary anatomic and reverse shoulder arthroplasty.Journal of shoulder and elbow arthroplasty · 2026Article
- Pain Management Strategies in Reverse Total Shoulder Arthroplasty.Current reviews in musculoskeletal medicine · 2026Review
- Dexamethasone has a synergistic effect on liposomal bupivacaine in reducing postoperative pain after total shoulder arthroplasty.JSES reviews, reports, and techniques · 2025Article
- Rebound Pain-Management Strategies for Transitional Analgesia: A Narrative Review.Journal of clinical medicine · 2025Review
- Postoperative pain control for shoulder arthroplasty.Clinics in shoulder and elbow · 2024Article
- Preoperative Risk Factors for Pain After Reverse Total Shoulder Arthroplasty: A Systematic Review.Cureus · 2024Review
- Comparison of the Effect of Adding Dexmedetomidine as an Adjuvant to Bupivacaine for Postoperative Pain Management in Patients Undergoing Shoulder Rotator Cuff Repair - A Randomized Clinical Trial.Advanced biomedical research · 2024Article
- Group-based trajectory analysis of acute pain after spine surgery and risk factors for rebound pain.Frontiers in medicine · 2022Article
- Reliability Analysis of Deep Learning Algorithms for Reporting of Routine Lumbar MRI Scans.International journal of spine surgery · 2020Article
- Feasibility of Deep Learning Algorithms for Reporting in Routine Spine Magnetic Resonance Imaging.International journal of spine surgery · 2020Article
- Reverse shoulder replacement: a day-case procedure.JSES international · 2020Article
- Outpatient narcotic consumption following total shoulder arthroplasty.JSES international · 2020Article
- Risk factors predicting less favorable outcomes in endoscopic lumbar discectomies.Journal of spine surgery (Hong Kong) · 2020Article
- Does Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review.International journal of environmental research and public health · 2019Review
- Short-Term Results of the DePuy Global Unite Platform Shoulder System: A Two-Year Outcome Study.The archives of bone and joint surgery · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOur institution's traditional pain management strategy after shoulder arthroplasty has involved the utilization of postoperative patient-controlled narcotic analgesia. More recently, we have implemented a protocol (TLC) that utilizes a multimodal approach. The purpose of this study was to determine whether this change has improved pain control and decreased narcotic utilization.
methodsPatients undergoing primary total shoulder or reverse arthroplasty were retrospectively studied. All patients underwent interscalene brachial plexus blockade. "Traditional" patients were provided a patient-controlled analgesic pump postoperatively. TLC patients were given 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 considered.
resultsThere were 108 patients in each group. Total postoperative narcotic consumption in the first 24 postoperative hours was 38.5 +/- 81.1 MEU in the "Traditional group" compared to 59.3 +/- 59.1 MEU in the TLC group (
conclusionThose treated with the TLC protocol had greater narcotic utilization but better VAS pain scores at 24 hours after surgery. Both groups experienced rebound pain. While the TLC protocol led to an improved pain experience, further modification of the currently protocol may be necessary to reduce overall narcotic utilization.
Indexed as
Identifiers
29911136PMC5990720W2790953440What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.