Postoperative joint replacement pain: description and opioid requirement

The present research was designed to describe the character, severity, and factors associated with postoperative pain following total hip replacement (THR) and total knee replacement (TKR) surgery, and to identify amounts of opioid required to relieve that pain. It was the investigators' intention to investigate the impact of age on severity of pain and amount of opioid required after surgery. Complete data were obtained on 29 white subjects, 16 of whom were men. Subjects' ages ranged from 27 to 88 years (mean, 66). The mean age for the men was 61 years and the mean age for the women was 72 years. Twelve subjects underwent THR and 17 underwent TKR. Eight patients received general anesthesia and 21 received spinal anesthesia. Pain was described using the McGill Pain Questionnaire-Short Form and quantified using a visual analogue scale. Amount of opioid required to relieve pain over 24 hours was recorded using a patient-controlled analgesia pump. Data analysis indicated that most patients do not report their pain as being controlled when discharged from the PACU, and that patients who receive spinal anesthesia require more postoperative opioid to control pain than patients who receive general anesthesia. In general, patients who undergo TKR experience more pain than patients who undergo THR. Pain was described as moderate to severe aching. As age increases, patients self-administer less postoperative opioid, but they do not report less postoperative pain.