Background: Opioid-sparing postoperative pain management therapies are important considering the opioid epidemic. Total knee arthroplasty (TKA) is a common and painful procedure accounting for a large number of opioid prescriptions. Adjuvant analgesics, nonopioid drugs with primary indications other than pain, have shown beneficial pain management and opioid-sparing effects following TKA in clinical trials. We evaluated the adjuvant analgesic gabapentin for its usage patterns and its effects on opioid use, pain, and readmissions.
Methods: This retrospective, observational study included 4,046 patients who received primary TKA between 2009 and 2017 using electronic health records from an academic tertiary care medical institute. Descriptive statistics and multivariate modeling were used to estimate associations between inpatient gabapentin use and adverse pain outcomes as well as inpatient oral morphine equivalents per day (OME).
Results: Overall, there was an 8.72% annual increase in gabapentin use (P < 0.001). Modeled estimates suggest that gabapentin is associated with a significant decrease in opioid consumption (estimate = 0.63, 95% confidence interval = 0.49-0.82, P < 0.001) when controlling for patient characteristics. Patients receiving gabapentin had similar discharge pain scores, follow-up pain scores, and 30-day unplanned readmission rates compared with patients receiving no adjuvant analgesics (P > 0.05).
Conclusions: When assessed in a real-world setting over a large cohort of TKA patients, gabapentin is an effective pain management therapy that is associated with reduced opioid consumption-a national priority in this time of opioid crisis-while maintaining the same quality of pain management.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147384 | PMC |
http://dx.doi.org/10.1093/pm/pnz053 | DOI Listing |
Cureus
December 2024
Psychiatry, Drexel University College of Medicine, West Reading, USA.
Complex regional pain syndrome (CRPS) is a chronic pain disorder characterized by severe, disproportionate pain relative to an inciting event. The disorder's pathophysiology is complex, involving both central and peripheral nervous system alterations, alongside genetic, inflammatory, and psychological factors. Using data from TriNetX, this study investigated the impact of analgesic and adjuvant therapies on psychiatric outcomes in CRPS patients.
View Article and Find Full Text PDFCureus
December 2024
Anesthesiology and Critical Care, Uttar Pradesh University of Medical Sciences, Etawah, IND.
Background: In epidural anaesthesia, the addition of an adjuvant to local anaesthetics enhances the efficacy, thereby providing increased duration and intensity of blockade in lower limb surgeries. The aim was to compare the efficacy, onset, and duration of sensory and motor blockade; haemodynamic changes; and sedative and analgesic effects of nalbuphine, clonidine, and dexmedetomidine as an adjuvant to ropivacaine in epidural anaesthesia.
Methodology: A prospective, randomised, double-blind study among 90 patients after taking consent was divided into three groups (30 patients each; Group D received 15 ml of 0.
BMC Anesthesiol
January 2025
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, No.95 Yongan Road, Beijing, Xicheng District, 100050, China.
Background: As a popularly used analgesic adjuvant, intravenous (IV) lidocaine could reduce the consumption of propofol in painless gastrointestinal (GI) endoscopy. However, whether IV lidocaine could affect the incidence of oxygen-desaturation episodes (ODE) during painless GI endoscopy is still unknown. Therefore, we tested the hypothesis that IV lidocaine could decrease the incidence of propofol-induced ODE and involuntary movements in patients during GI endoscopy.
View Article and Find Full Text PDFInt J Mol Sci
January 2025
Nursing Department, College of Staten Island, City University of New York, Staten Island, NY 10314, USA.
Kidney stones typically present as renal colic in emergency departments (EDs), where patients experience severe pain and often require parenteral therapy for symptom management. The economic burden associated with managing kidney stones exceeds USD 5 billion annually in the US and accounts for more than a million visits to EDs each year. There is clear evidence emphasizing the need for innovative and alternative pain control options for patients with renal colic.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405.
Dysregulation of GABAergic inhibition is associated with pathological pain. Consequently, enhancement of GABAergic transmission represents a potential analgesic strategy. However, therapeutic potential of current GABA agonists and modulators is limited by unwanted side effects.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!