Comparison of Oral Opioid and Intravenous (IV) Non-opioid Based Analgesia in Early Postoperative Pain Management Following Total Knee Arthroplasty: A Retrospective Study
Abstract
Abstract Background Total knee arthroplasty (TKA) is followed by severe postoperative pain that affects postoperative rehabilitation, patient satisfaction, and overall outcomes. This study compared the postoperative pain reduction and potential side effects of two postoperative pain protocols (oral opioid analgesia vs. intravenous (IV) non-opioid based analgesia) following TKA. Methods This comparative retrospective study included 276 patients who underwent primary TKA. The patients were categorized into two groups, each having 138 patients. Patients in group 1 were administered oral opioid-based analgesics (oxycodone/acetaminophen or hydrocodone/acetaminophen) while patients in group 2 received non-opioid pain analgesics including intravenous ketorolac, paracetamol followed by oral celecoxib. Pain was assessed using the numeric rating scale (NRS) preoperatively and at weekly follow-up from week 1 through week 6, and patient satisfaction was measured on a 100-point scale. Side effects including postoperative delirium, urinary retention, and gastrointestinal complications (nausea, vomiting, and constipation) were recorded. Between-group comparisons used independent-samples t-tests and chi-square or Fisher exact tests, with analysis of covariance (ANCOVA) and multivariable logistic regression to adjust for age, sex, body mass index (BMI), and procedure type. Results Postoperative NRS pain scores were significantly lower in the IV non-opioid multimodal group (group 2) than in…
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