ArticleCureus2024
Role of Strong Opioids in an Effective Discharge for Lower-Limb Large Joint Arthroplasty Patients: A Patient-Based Analysis.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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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.
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1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectiveAdequate postoperative analgesics are an essential element in the recovery and rehabilitation of large joint lower-limb arthroplasty patients in their acute postoperative phase. In this study, we will establish that strong opioids like morphine should be included as postoperative analgesics to improve patient satisfaction. Material: This retrospective cross-sectional study was conducted in the Arthroplasty Ward, Trauma, and Orthopaedics Department in a district general hospital of the United Kingdom. Fifty patients operated in January 2024 were enrolled in this study, out of which 25 had total hip replacement and 25 had total knee replacement. Patients were divided into two groups based on analgesics given at the time of discharge. Group A had a strong opioid and Group B had a non-steroidal anti-inflammatory drug (NSAID) plus weak opioids upon discharge. Patients with hospital stays of more than four days and patients with allergies to any analgesics were excluded. Results: Forty percent (40%) of the patients in the total hip replacement (THR) group and fifty percent (50%) in the total knee replacement (TKR) group were discharged on adequate analgesia (NSAID + weak opioids + strong opioids) and all reported manageable postoperative pain. A significant difference in pain scores on the fifth postoperative day (POD) was observed between the two groups (p = 0.001). Patient satisfaction levels also differed notably between the groups, with significant variance (p = 0.011). Group A showed a higher rate of "very satisfied" patients (n = 3).
conclusionAdequate analgesics prescribing is an integral part of enhanced recovery after surgery (ERAS) guidelines for patients undergoing knee and hip arthroplasties. Pain has catabolic systemic consequences for patients and delays postoperative recovery. We have proposed the step ladder pattern of analgesics for such patients, in which strong opioids should be given to aid in pain relief. Apart from this, a virtual consultation should be done by an arthroplasty nurse within one week of operation for their pain assessment as the pain scale.
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