A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty

H. B J Fischer, C. J P Simanski, C. Sharp, F. Bonnet, F. Camu, E. A M Neugebauer, N. Rawal, G. P. Joshi, S. A. Schug, H. Kehlet

Research output: Contribution to journalReview article

212 Scopus citations

Abstract

The PROSPECT Working Group, a collaboration of anaesthetists and surgeons, conducts systematic reviews of postoperative pain management for different surgical procedures (http://www.postoppain.org). Evidence-based consensus recommendations for the effective management of postoperative pain are then developed from these systematic reviews, incorporating clinical practice observations, and transferable evidence from other relevant procedures. We present the results of a systematic review of pain and other outcomes following analgesic, anaesthetic and surgical interventions for total knee arthroplasty (TKA). The evidence from this review supports the use of general anaesthesia combined with a femoral nerve block for surgery and postoperative analgesia, or alternatively spinal anaesthesia with local anaesthetic plus spinal morphine. The primary technique, together with cooling and compression techniques, should be supplemented with paracetamol and conventional non-steroidal anti-inflammatory drugs or COX-2-selective inhibitors, plus intravenous strong opioids (high-intensity pain) or weak opioids (moderate- to low-intensity pain).

Original languageEnglish (US)
Pages (from-to)1105-1123
Number of pages19
JournalAnaesthesia
Volume63
Issue number10
DOIs
StatePublished - Oct 1 2008

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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