Dr. Tannenbaum's Corner: Novel Postoperative Pain Management

After you have decided to have joint replacement surgery, there are undoubtedly many concerns that come to mind. One of the greatest is the pain that is to be expected after surgery. Fortunately, the doctors at Southern Indiana Orthopedics are working on cutting-edge techniques to improve this aspect of your care.

Traditionally, a spinal block in combination with a general anesthetic has been the main mode of pain control. Intravenous narcotics and oral pain pills have been used in the postoperative period to help control pain after surgery. These methods have had their problems, including excessive nausea and vomiting in addition to low blood pressure and poor pain control.

Today's strategy has changed. We are now avoiding the use of spinal anesthetics and decreasing narcotic usage to eliminate many side effects. A multi-modal approach has been developed that includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs), intravenous acetaminophen, long-acting numbing agents, and selective nerve blocks.

Intravenous NSAIDs and acetaminophen have been shown to decrease both postoperative swelling and pain without any of the stomach side effects that can occur with oral forms of pain control. Most novel is the use of a new, long-acting form of the numbing agent bupivacaine, where your surgeon can inject it in your incision during surgery to provide up to 96 hours of pain relief without the blood pressure issues and nausea associated with a spinal block. In addition, peripheral nerve blocks are being done to help decrease pain in the immediate postoperative period. This multi-modal approach has greatly improved patient satisfaction and allowed patients to participate in therapy quicker and more efficiently. Certainly, oral pain pills are also available, if needed.

Understanding how to control your pain postoperatively is important to maximize your outcome. At Southern Indiana Orthopedics, we are working on the latest approaches to pain management that comes with an excellent hip or knee replacement experience.