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Related Concept Videos

Analgesia and Pain Management01:25

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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...
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Structural Joints: Synovial Joints01:16

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Synovial joints are the most common type of joint in the body. A key structural characteristic for a synovial joint is the presence of a joint cavity. This fluid-filled space is where the articulating surfaces of the bones contact each other. Also, unlike fibrous or cartilaginous joints, the articulating bone surfaces at a synovial joint are not directly connected to each other with fibrous connective tissue or cartilage. This gives the bones of a synovial joint the ability to move smoothly...
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Structural Joints: Fibrous Joints01:03

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Fibrous joints are a type of joint where the bones are connected by fibrous connective tissue. These joints provide stability and minimal to no movement between the articulating bones. There are three types of fibrous joints.
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All the bones of the skull, except for the mandible, are joined to each other by a fibrous joint called a suture. The fibrous connective tissue found at a suture strongly unites the adjacent skull bones and thus helps to protect the brain and form the face. In...
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Structural Joints: Cartilaginous Joints01:17

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As the name indicates, at a cartilaginous joint, the adjacent bones are united by cartilage, a tough but flexible type of connective tissue. Unlike synovial joints, these types of joints lack a joint cavity and involve bones joined together by either hyaline cartilage or fibrocartilage.
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Joints, also called articulations or articular surfaces, are points at which ligaments or other tissues connect adjacent bones. Joints permit movement and stability, and can be classified based on their structure or function.
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The digestive system is responsible for the ingestion of food, secretion of enzymes, mixing and digesting food, absorption of the nutrients and defecation. The human digestive system consists of two major parts: the gastrointestinal tract and the accessory digestive organs.
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Multimodal Pain Management for Major Joint Replacement Surgery.

Victoria M Goode1, Brett Morgan, Virginia C Muckler

  • 1Victoria M. Goode, PhD, CRNA, Duke University School of Nursing, Durham, NC. Brett Morgan, DNP, CRNA, Duke University School of Nursing, Durham, NC. Virginia C. Muckler, DNP, CRNA, CHSE, Duke University School of Nursing, Durham, NC. Michael P. Cary, Jr., PhD, RN, Duke University School of Nursing, Durham, NC. Christine E. Zdeb, BSN, RN, ONC, Duke University School of Nursing, Durham, NC. Michael Zychowicz, DNP, ANP, ONP, FAAN, FAANP, Duke University School of Nursing, Durham, NC.

Orthopedic Nursing
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Summary

Multimodal pain management, using various analgesics and techniques, is crucial for orthopedic joint replacement recovery. Understanding patient history and pain mechanisms optimizes this approach, reducing opioid dependency and improving outcomes.

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Area of Science:

  • Orthopaedic Surgery
  • Pain Management
  • Pharmacology

Background:

  • Effective pain management post-orthopaedic major joint replacement is vital for patient recovery, function, and satisfaction.
  • Multimodal pain management strategies are increasingly adopted to reduce opioid dependency.
  • Patient medication history significantly influences the success of multimodal pain regimens.

Purpose of the Study:

  • To highlight the importance of multimodal pain management in orthopaedic surgery.
  • To outline the components of a multimodal pain management strategy.
  • To emphasize the nurse's role in understanding pain mechanisms and adjuncts for perioperative care.

Main Methods:

  • Review of current literature on multimodal pain management in orthopaedics.
  • Discussion of various analgesic agents including NSAIDs, acetaminophen, NMDA antagonists, gabapentin, and serotonin inhibitors.
  • Inclusion of regional techniques and opioid-sparing strategies.

Main Results:

  • Multimodal pain management combines multiple analgesic agents and techniques for enhanced pain control.
  • Key components include NSAIDs, acetaminophen, gabapentin, NMDA antagonists, regional anesthesia, and judicious opioid use.
  • Preoperative medication use and patient history are critical factors for regimen success.

Conclusions:

  • Multimodal pain management is essential for optimizing outcomes in major joint replacement surgery.
  • Nurses must understand pain mechanisms and the role of adjuncts for effective perioperative, postoperative, and discharge management.
  • This approach aims to improve patient recovery, function, and satisfaction while minimizing opioid reliance.