Memantine as a pain management strategy post-total knee arthroplasty: a randomized controlled trial

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Pharmacology

Background:

• Total knee arthroplasty (TKA) is effective for knee osteoarthritis but postoperative pain management remains challenging.
• Effective acute pain management post-TKA is crucial for patient recovery and improved outcomes.
• Investigating novel pharmacological agents like memantine is essential for optimizing TKA pain control.

Purpose of the Study:

• To evaluate the efficacy of memantine in reducing postoperative pain following total knee arthroplasty (TKA).
• To assess the impact of memantine on patient-reported pain scores and opioid consumption after TKA.
• To determine if memantine influences nocturnal awakenings in the TKA postoperative period.

Main Methods:

• A double-blind, randomized controlled trial involving adult patients undergoing TKA.
• Participants received either oral memantine (preoperative and postoperative) or a placebo, alongside standard analgesics.
• Pain was assessed using Visual Analog Scale (VAS) and Short-Form McGill Pain Questionnaire (SF-MPQ), with opioid usage and nocturnal awakenings as secondary outcomes.

Main Results:

• Memantine did not significantly reduce pain scores compared to placebo on VAS or SF-MPQ.
• Patients receiving memantine required significantly fewer opioid analgesics postoperatively compared to the placebo group.
• No significant difference in nocturnal awakenings was observed between the memantine and placebo groups.

Conclusions:

• Oral memantine does not significantly alleviate pain levels in patients undergoing total knee arthroplasty.
• Memantine significantly reduces the requirement for postoperative opioid analgesia in TKA patients.
• Further research may explore memantine's role in opioid-sparing strategies within multimodal TKA pain management protocols.