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Pain Management for Periacetabular Osteotomy: A Systematic Review
Kyle P O'Connor1, John C Davidson2, Jeffrey J Nepple1
1Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
The Iowa Orthopaedic Journal
|June 26, 2024
Summary
Supplemental pain management strategies like nerve blocks can reduce pain and hospital stays after periacetabular osteotomy (PAO) surgery. Further clinical trials are needed to confirm the efficacy of these interventions for faster recovery.
Area of Science:
- Orthopaedic Surgery
- Pain Management
- Anesthesiology
Background:
- Periacetabular osteotomy (PAO) is a key treatment for hip dysplasia.
- Effective early post-operative pain control is crucial for recovery after PAO.
- Limited evidence exists on non-opioid pain management strategies for PAO.
Purpose of the Study:
- To systematically review the efficacy of non-opioid supplemental pain management interventions after PAO.
- To assess the impact of these strategies on pain reduction, mobilization, and length of hospital stay.
Main Methods:
- Systematic review conducted following PRISMA guidelines.
- Searched multiple databases including PubMed, Embase, and clinicaltrials.gov.
- Included six studies investigating nerve blocks, local wound infiltration, dexamethasone, and epidural catheter removal timing.
Main Results:
- Nerve blocks generally reduced opioid use, pain, and length of stay.
- Local wound infiltration decreased pain on postoperative days 3 and 4.
- Early epidural catheter removal (POD 1 vs. POD 2) reduced pain and length of stay; dexamethasone showed limited benefits.
Conclusions:
- Supplemental peri-operative pain management strategies can decrease pain, opioid use, and hospital stay after PAO.
- Few studies currently assess these interventions, highlighting a need for more research.
- Limiting opioid use facilitates recovery and reduces adverse effects, underscoring the importance of effective non-opioid strategies.
