Related Experiment Video
Updated: Feb 23, 2026
04:41
Knee Arthrocentesis in Adults
Published on: February 25, 2022
9.8K
Narcotic Use and Total Knee Arthroplasty
Jourdan M Cancienne1, Kishan J Patel2, James A Browne1
1Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia.
The Journal of Arthroplasty
|September 10, 2017
Summary
Preoperative and prolonged postoperative narcotic use increases the risk of complications after total knee arthroplasty (TKA). Limiting narcotic prescriptions perioperatively may improve TKA outcomes.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Public Health
Background:
- The United States faces a significant narcotic epidemic.
- Risk factors and outcomes associated with perioperative narcotic use in total knee arthroplasty (TKA) are not well understood.
Purpose of the Study:
- To identify risk factors for prolonged narcotic use in TKA patients.
- To evaluate the impact of preoperative and prolonged postoperative narcotic use on TKA complications.
Main Methods:
- A national database was queried for primary TKA patients (2007-2015).
- Patients with preoperative and prolonged postoperative narcotic use were identified.
- Regression analysis assessed risk factors and complication rates.
Main Results:
- Over 113,000 TKA patients were analyzed.
- Preoperative narcotic prescriptions were the strongest predictor of prolonged postoperative use.
- Preoperative and prolonged postoperative narcotic use were linked to increased risks of complications including infection, stiffness, and revision.
Conclusions:
- Narcotic use before and after TKA is associated with higher complication rates.
- Perioperative narcotic management is a critical factor for optimizing TKA outcomes.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
1.2K
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
1.2K
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
1.2K
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
1.2K
01:25Analgesia and Pain Management
2.3K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
2.3K
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
853
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
853
01:24Parenteral Anesthetics: Overview
805
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
805
01:23Local Anesthetics: Common Agents and Their Applications
1.0K
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
1.0K