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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain control in total joint arthroplasty: a prospective, randomized study of a fixed-dose, around-the-clock, oral regimen.
- D A Flory, R A Fankhauser, and M A McShane.
- Department of Orthopedic Surgery, Mt Carmel Health System, Columbus, Ohio, USA.
- Orthopedics. 2001 Mar 1;24(3):243-6.
AbstractThis randomized, prospective study assessed postoperative pain control in 119 patients undergoing total joint arthroplasty. Group 1 (59 patients) received scheduled, around-the-clock, oral opioids and group 2 (60 patients) received oral opioids on an as-needed basis. Both groups had parenteral opioids available for breakthrough pain. The average scores for group 1 were lower than group 2. Differences were significant in sensory scores (AM day 1; AM and PM day 2), affective scores (PM day 2), total pain (PM day 2), visual analog scale (PM day 2), and present pain intensity index (AM day 1; PM day 2). Group 1 averaged 2.05 breakthrough pain doses and group 2 averaged 3.47 doses (P=.003), an average savings of 17.2% of the cost of pain medications during the first 2 postoperative days. The results indicate that scheduled, around-the-clock, oral opioids are an effective treatment regimen for postoperative pain control in total joint arthroplasty patients.
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