Yavuz Orak

By Yavuz Orak and Mahmut Arslan

Postoperative pain is caused by neuronal damage that occurs during the surgical procedure and the stimulation of the nociceptors. In postoperative period, total knee arthroplasty (TKA) is painful, and pain management is quite difficult. The main purpose of postoperative pain relief is to reduce the pain of the patient, to contribute to the healing process, to shorten the length of hospital stay, and to reduce hospital costs. Techniques such as intravenous analgesia, epidural analgesia, and peripheral nerve blocks are used to prevent postoperative pain. In addition, oral and parenteral analgesics, patient-controlled analgesia (PCA), nerve blocks, and periarticular injection methods are used as multimodal analgesia methods. Pain scales such as visual analogue scale (VAS), verbal descriptive scale (VDS), and numerical rating scale (NRS) are used as the standard methods in the evaluation of pain of patients. Systemic opioids, nonsteroidal anti-inflammatory drugs, and local anesthetics are used for postoperative analgesia. Preemptive analgesia, defined as analgesia initiated prior to surgical incision, and multimodal analgesia have been shown to reduce opioid consumption associated with high complication rates. Postoperative pain management should be planned considering the clinical characteristics of the patient, experience of the anesthetist, and clinical facilities. Early postoperative analgesia reduces systemic complication rates and improves early rehabilitation, patient satisfaction, and quality of life.

Part of the book: Primary Total Knee Arthroplasty