Assuring a Painless Total Hip Arthroplasty: A Multimodal Approach Emphasizing Peripheral Nerve Blocks

Mark Pagnano, James Hebl, Terese Horlocker

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

A highly effective comprehensive multimodal pain protocol has evolved at our institution for both primary and revision hip and knee arthroplasty. At the center of this protocol are peripheral nerve blocks to deliver postoperative pain relief. Total hip arthroplasty patients receive a lumbar plexus block with an indwelling catheter. Total knee arthroplasty patients receive a femoral nerve block with an indwelling catheter and also get a single-shot sciatic nerve block. Before surgery, patients are given a long-acting oral narcotic medication and a nonsteroidal anti-inflammatory. After surgery, oral medications are given on a set schedule and include acetaminophen, a nonsteroidal anti-inflammatory, and a long-acting oral narcotic. Outstanding pain control is achieved without parenteral narcotics and allows early physical therapy, early return to self-care, and improved patient satisfaction.

Original languageEnglish (US)
Pages (from-to)80-84
Number of pages5
JournalJournal of Arthroplasty
Volume21
Issue number4 SUPPL.
DOIs
StatePublished - Jun 1 2006

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Nerve Block
Narcotics
Peripheral Nerves
Arthroplasty
Hip
Knee Replacement Arthroplasties
Indwelling Catheters
Anti-Inflammatory Agents
Lumbosacral Plexus
Femoral Nerve
Pain
Sciatic Nerve
Acetaminophen
Self Care
Postoperative Pain
Secondary Prevention
Patient Satisfaction
Appointments and Schedules

Keywords

  • analgesia
  • pain management
  • regional anesthesia
  • total hip arthroplasty
  • total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Assuring a Painless Total Hip Arthroplasty : A Multimodal Approach Emphasizing Peripheral Nerve Blocks. / Pagnano, Mark; Hebl, James; Horlocker, Terese.

In: Journal of Arthroplasty, Vol. 21, No. 4 SUPPL., 01.06.2006, p. 80-84.

Research output: Contribution to journalArticle

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