ArticleJournal of pain research2026
Association of a Physician-Nurse Collaborative Multimodal Analgesic Pathway with Early Pain Trajectories and Institution-Recorded Opioid Use After Total Knee Arthroplasty: A Propensity Score-Matched Retrospective Cohort Study.
Article in Journal of pain research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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Authors and funding
7 authors.
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Abstract
Background: Multimodal analgesia is widely used after total knee arthroplasty (TKA), but evidence regarding the real-world effectiveness of bundled opioid-sparing pathways remains limited. This study compared a standardized physician-nurse collaborative pathway with conventional care delivered during an earlier historical period. Methods: This single-center retrospective cohort study included adults undergoing primary unilateral TKA. The modified pathway combined physician-prescribed scheduled celecoxib and tramadol/paracetamol rescue analgesia with nurse-delivered cryotherapy, limb elevation, relaxation training, and perioperative pain education. Propensity score matching was used to balance measured baseline and perioperative characteristics. Primary outcomes were longitudinal resting Visual Analog Scale (VAS) scores and cumulative institution-recorded opioid exposure within 90 days, expressed as oral morphine milligram equivalents (MME). Secondary outcomes included continued institution-recorded opioid prescribing at 90 days, opioid-induced adverse events, functional scores, and length of stay. Results: After matching, 101 patient pairs were analyzed. The group-by-time interaction for resting VAS scores was significant (Wald χ Conclusion: The bundled physician-nurse collaborative pathway was associated with lower early pain scores, reduced institution-recorded opioid exposure, and less continued opioid prescribing after TKA. Prospective studies with concurrent controls are needed to confirm these findings and determine the contribution of individual pathway components.
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