[Clinical aspects of the service of acute postoperative pain treatment].

Purpose Of The Study: To analyze work results of the service of acute postoperative pain treatment in the orthopedic hospital. DISIGN: Single-center retrospective observational cohort study.

Patients And Methods: We studied 1343 patients underwent total hip arthroplasty (64%), total knee arthroplasty (33%), and revision surgeries (3%). The average age of the patients was 59 ± 12 years, and body mass index was 30 ± 6. All patients received triple pain therapy in postoperative period which included pracetamol, NSA IDs or specific ciclooxygenase-2 inhibitor and epidural analgesia or peripheral blockade and patient controlled intravenous or epidural analgesia. The pain intensity was recorded four times a day--every 6 hours during 2 days after surgeries.

Results: All patients received oral or intravenous analgesics. 90% of patients received prolonged epidural infusion, 10%--prolonged block of the femoral nerve after total knee arthroplasty. Patient controlled analgesia was used in 6-10% of patients. Average pain intensity was 20 mm according to VAS. Pain intensity over 40 mm was observed in 8-13% of patients at 1st day after surgery and in 2-15% at 2nd day after surgery. Deep vein thrombosis was found in 5.7% of patients, and bleeding in 0.2%. Length of stay in a hospital after total hip arthroplasty and total knee arthroplasty was 6 ± 2 days and 10 ± 8 days after revision surgeries.

Conclusions: The work of the service of acute postoperative pain treatment in the orthopedic hospital, the use of multimodal treatment protocols and mandatory clinical monitoring provide proper control of postoperative pain, patient satisfaction, and allow to accelerate early recovery and reduce the time of postoperative hospital stay after total replacement of large joints.