Postoperative Pain Management Strategies in Hip Arthroscopy

AbstractPurpose of ReviewHip arthroscopy is a rapidly growing field due to its significant diagnostic and therapeutic value in the management of numerous hip disorders. Adequate control of postoperative pain in patients undergoing hip arthroscopy continues to be a challenging and evolving area in orthopedics. In the absence of standardized protocols for pain management in these patients, a variety of different approaches have been utilized in an effort to find a regimen that is effective at reducing postoperative pain, narcotic consumption, and cost to the patient and healthcare system. The purpose of this article, therefore, is to provide a comprehensive review of current literature regarding postoperative pain management techniques in patients undergoing hip arthroscopy.Recent FindingsRecent literature demonstrates the importance of a multimodal approach to treat postoperative pain in patients undergoing hip arthroscopy. When a peripheral nerve block or intraoperative anesthetic is used in combination with a pre- and postoperative analgesic medication regimen, patients report less pain and postoperative narcotic consumption. Patient-reported pain scores and postoperative opioid use were similar between the different modalities, however, postoperative complications appear to be less in groups receiving intra-articular (IA) injection or local anesthetic infiltration (LAI) compared to peripheral nerve blocks.SummaryIn summary, we present evidence that intraoperative techniques...
Source: Current Reviews in Musculoskeletal Medicine - Category: Orthopaedics Source Type: research

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ConclusionWith this local –regional nerve-blocking protocol, opioid use after ARCR was unexpectedly low, and a large proportion of patients recovered without any post-surgical opioids. The correlation seen between opioid use and age may not be clinically significant, given the low use of post-operative opioids overall. The se results may be useful in guiding post-operative opioid prescribing after ARCR, as well as in lowering costs associated with ARCR.
Source: HSS Journal - Category: Orthopaedics Source Type: research
ConclusionsUnplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge.ResumenObjetivoLos procedimientos de Cirugía Ortopédica y Traumatología (COT) realizados en Unidades de Cirugía Mayor Ambulatoria (CMA) ofrecen importantes ventajas que desaparecen cuando la recuperación postoperatoria no es la...
Source: Revista Espanola de Cirugia Ortopedica y Traumatologia - Category: Orthopaedics Source Type: research
Authors: Plečko M, Bohaček I, Tripković B, Čimić M, Jelić M, Delimar D Abstract Anterior section of the hip joint capsule is innervated by femoral nerve and obturator nerve, and posterior section is innervated by the nerve to quadratus femoris muscle and occasionally by the superior gluteal (posterolateral region) and sciatic nerve (posterosuperior region). One of the regional anesthesia options for hip surgery is the fascia iliaca compartment block (FICB) that affects nerves important for hip innervation and sensory innervation of the thigh - femoral, obturator and lateral femoral cutaneous nerve. FICB can b...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
Authors: Cho CH, Bae KC, Kim DH Abstract Frozen shoulder (FS) is a common shoulder disorder characterized by a gradual increase of pain of spontaneous onset and limitation in range of motion of the glenohumeral joint. The pathophysiology of FS is relatively well understood as a pathological process of synovial inflammation followed by capsular fibrosis, but the cause of FS is still unknown. Treatment modalities for FS include medication, local steroid injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic capsular release, and open capsular release. Conservative management leads to i...
Source: Clinics in Orthopedic Surgery - Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research
The opioid epidemic continues to be a problem in the United States and prescription opioid overdose fatalities continue to rise. Chronic opioid use threatens military readiness and puts service members at risk for medical separation from military service. Orthopedic surgeons commonly prescribe opioid medications for postsurgical patients. Long-term opioid use can be the result of acute, postoperative opioid intake. Overprescribing may increase the risk of long-term opioid use, medication diversion and adverse outcomes. Preoperative administration of opioids dramatically increases the risk of continued use up to 1 year afte...
Source: Sports Medicine and Arthroscopy Review - Category: Sports Medicine Tags: Review Articles Source Type: research
Phys. Chem. Chem. Phys., 2019, Accepted Manuscript DOI: 10.1039/C9CP01878F, PaperRama Prajapati , Susan Weng Larsen, Anan Yaghmur Improvement of pain management strategies after arthroscopic surgery by multimodal analgesia may include the use of long-acting amide local anesthetics. Among these anesthetics, the low molecular weight local anesthetic agent... The content of this RSS Feed (c) The Royal Society of Chemistry
Source: RSC - Phys. Chem. Chem. Phys. latest articles - Category: Chemistry Authors: Source Type: research
Abstract Arthrofibrosis is the pathologic stiffening of a joint caused by an exaggerated inflammatory response. As a common complication following total knee arthroplasty (TKA), this benign-appearing connective tissue hyperplasia can cause significant disability among patients because the concomitant knee pain and restricted range of motion severely hinder postoperative rehabilitation, clinical outcomes, and basic activities of daily living. The most effective management for arthrofibrosis in the setting of TKA is prevention, including preoperative patient education programs, aggressive postoperative physical ther...
Source: The Orthopedic Clinics of North America - Category: Orthopaedics Authors: Tags: Orthop Clin North Am Source Type: research
Arthrofibrosis is the pathologic stiffening of a joint caused by an exaggerated inflammatory response. As a common complication following total knee arthroplasty (TKA), this benign-appearing connective tissue hyperplasia can cause significant disability among patients because the concomitant knee pain and restricted range of motion severely hinder postoperative rehabilitation, clinical outcomes, and basic activities of daily living. The most effective management for arthrofibrosis in the setting of TKA is prevention, including preoperative patient education programs, aggressive postoperative physical therapy regimens, and ...
Source: Orthopedic Clinics of North America - Category: Orthopaedics Authors: Source Type: research
Authors: Demir U, Ince I, Aksoy M, Dostbil A, Arı MA, Sulak MM, Kose M, Tanios M, Ozmen O Abstract BACKGROUND: Postoperative pain is an important problem for patients undergoing shoulder surgery. Our study investigated analgesic efficacy, duration of analgesia, postoperative analgesic use and patient satisfaction with the use of preemptive intravenous dexketoprofen for interscalene block in addition to general anesthesia in arthroscopic shoulder surgery. METHODS: 60 patients, scheduled for arthroscopic shoulder surgery were randomized (30 patients each) into either: - control group (Group1) or dexketoprofen gr...
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
ConclusionIncreased postoperative administration of dexamethasone and gabapentin after TKA is associated with lower opioid consumption. Within the first 48  h, up to about 25% of opioids can be spared, comparing high-dose to low-dose protocols.Level of evidenceTherapeutic Level III.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
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