Efficacy of Adding Acetaminophen to Preemptive Multimodal Analgesia in Total Knee Arthroplasty: A Double‐blinded Randomized Study
Objective Preemptive multimodal analgesia is a frequently utilized method for controlling pain after total knee arthroplasty (TKA). So far, no studies have specifically examined the efficacy of adding acetaminophen to preemptive multimodal analgesia in TKA. The current work aimed to assess the effic...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.13780 |
| _version_ | 1797693888354320384 |
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| author | Qiuru Wang Ting Ma Liying Wang Chengcheng Zhao Pengde Kang |
| author_facet | Qiuru Wang Ting Ma Liying Wang Chengcheng Zhao Pengde Kang |
| author_sort | Qiuru Wang |
| collection | DOAJ |
| description | Objective Preemptive multimodal analgesia is a frequently utilized method for controlling pain after total knee arthroplasty (TKA). So far, no studies have specifically examined the efficacy of adding acetaminophen to preemptive multimodal analgesia in TKA. The current work aimed to assess the efficacy of adding acetaminophen to preemptive multimodal analgesia for clinical pain management after TKA. Methods This was a double‐blinded randomized study including 80 cases randomized to the acetaminophen and control groups, respectively. The acetaminophen group was administered celecoxib at 400 mg, pregabalin at 150 mg, and acetaminophen at 300 mg 2 h before TKA. Control patients were administered celecoxib, pregabalin, and placebo. The primary outcome was postsurgical use of morphine hydrochloride for rescue analgesia. Secondary outcomes included the time to the initial rescue analgesia, postsurgical pain as determined by a visual analogue scale (VAS), functional recovery as reflected by the range of knee motion and ambulation distance, hospitalization duration, and complication rates. Continuous data with normal and skewed distributions were compared by the Student's t test and the Mann–Whitney U test, respectively. Categorical variables were compared by the Pearson's chi‐squared test. Results The control and acetaminophen groups were comparable in postoperative 0–24 h morphine consumption (11.3 ± 6.5 mg vs 12.3 ± 7.7 mg, P = 0.445) and total morphine consumption (17.3 ± 10.1 mg vs 19.3 ± 9.4 mg, P = 0.242). Additionally, time to the initial rescue analgesia, postoperative VAS score at any time point, postoperative functional recovery of the knee, and hospitalization duration were similar in both groups. Both groups also had similar occurrence rates of postoperative complications. Conclusions In this study, adding acetaminophen to preoperative preemptive multimodal analgesia did not decrease postoperative morphine use or ameliorate pain relief. The efficacy of adding acetaminophen to preemptive multimodal analgesia in TKA need to be further explored in future studies. |
| first_indexed | 2024-03-12T02:50:06Z |
| format | Article |
| id | doaj.art-4905c7d86f5849e8b08fc1d326b78703 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-03-12T02:50:06Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-4905c7d86f5849e8b08fc1d326b787032023-09-04T04:41:45ZengWileyOrthopaedic Surgery1757-78531757-78612023-09-011592283229010.1111/os.13780Efficacy of Adding Acetaminophen to Preemptive Multimodal Analgesia in Total Knee Arthroplasty: A Double‐blinded Randomized StudyQiuru Wang0Ting Ma1Liying Wang2Chengcheng Zhao3Pengde Kang4Department of Orthopedic Surgery West China Hospital, Sichuan University Chengdu ChinaOperating Room West China Hospital, Sichuan University/West China School of Nursing, Sichuan University Chengdu ChinaOperating Room West China Hospital, Sichuan University/West China School of Nursing, Sichuan University Chengdu ChinaDepartment of Orthopedic Surgery West China Hospital, Sichuan University Chengdu ChinaDepartment of Orthopedic Surgery West China Hospital, Sichuan University Chengdu ChinaObjective Preemptive multimodal analgesia is a frequently utilized method for controlling pain after total knee arthroplasty (TKA). So far, no studies have specifically examined the efficacy of adding acetaminophen to preemptive multimodal analgesia in TKA. The current work aimed to assess the efficacy of adding acetaminophen to preemptive multimodal analgesia for clinical pain management after TKA. Methods This was a double‐blinded randomized study including 80 cases randomized to the acetaminophen and control groups, respectively. The acetaminophen group was administered celecoxib at 400 mg, pregabalin at 150 mg, and acetaminophen at 300 mg 2 h before TKA. Control patients were administered celecoxib, pregabalin, and placebo. The primary outcome was postsurgical use of morphine hydrochloride for rescue analgesia. Secondary outcomes included the time to the initial rescue analgesia, postsurgical pain as determined by a visual analogue scale (VAS), functional recovery as reflected by the range of knee motion and ambulation distance, hospitalization duration, and complication rates. Continuous data with normal and skewed distributions were compared by the Student's t test and the Mann–Whitney U test, respectively. Categorical variables were compared by the Pearson's chi‐squared test. Results The control and acetaminophen groups were comparable in postoperative 0–24 h morphine consumption (11.3 ± 6.5 mg vs 12.3 ± 7.7 mg, P = 0.445) and total morphine consumption (17.3 ± 10.1 mg vs 19.3 ± 9.4 mg, P = 0.242). Additionally, time to the initial rescue analgesia, postoperative VAS score at any time point, postoperative functional recovery of the knee, and hospitalization duration were similar in both groups. Both groups also had similar occurrence rates of postoperative complications. Conclusions In this study, adding acetaminophen to preoperative preemptive multimodal analgesia did not decrease postoperative morphine use or ameliorate pain relief. The efficacy of adding acetaminophen to preemptive multimodal analgesia in TKA need to be further explored in future studies.https://doi.org/10.1111/os.13780AcetaminophenPainPreemptive analgesiaTotal knee arthroplasty |
| spellingShingle | Qiuru Wang Ting Ma Liying Wang Chengcheng Zhao Pengde Kang Efficacy of Adding Acetaminophen to Preemptive Multimodal Analgesia in Total Knee Arthroplasty: A Double‐blinded Randomized Study Orthopaedic Surgery Acetaminophen Pain Preemptive analgesia Total knee arthroplasty |
| title | Efficacy of Adding Acetaminophen to Preemptive Multimodal Analgesia in Total Knee Arthroplasty: A Double‐blinded Randomized Study |
| title_full | Efficacy of Adding Acetaminophen to Preemptive Multimodal Analgesia in Total Knee Arthroplasty: A Double‐blinded Randomized Study |
| title_fullStr | Efficacy of Adding Acetaminophen to Preemptive Multimodal Analgesia in Total Knee Arthroplasty: A Double‐blinded Randomized Study |
| title_full_unstemmed | Efficacy of Adding Acetaminophen to Preemptive Multimodal Analgesia in Total Knee Arthroplasty: A Double‐blinded Randomized Study |
| title_short | Efficacy of Adding Acetaminophen to Preemptive Multimodal Analgesia in Total Knee Arthroplasty: A Double‐blinded Randomized Study |
| title_sort | efficacy of adding acetaminophen to preemptive multimodal analgesia in total knee arthroplasty a double blinded randomized study |
| topic | Acetaminophen Pain Preemptive analgesia Total knee arthroplasty |
| url | https://doi.org/10.1111/os.13780 |
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