Easing Joint Replacement Pain

By Darryl Tannenbaum, M.D.

Once you have decided to have joint replacement, you’re likely to have a lot on your mind.

One of the greatest concerns is probably the pain you should expect after surgery. Fortunately, Columbus Regional Health and the Joint & Spine Center are working on cutting-edge techniques to improve this aspect of your care.

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

Head Start on Pain Control
Today, the strategy has changed. We no longer wait for pain to occur and then respond to it. Anticipating pain and treating it during surgery has provided a markedly superior experience for our patients.

We are now avoiding the use of spinal anesthetics and decreasing narcotic use to eliminate many side effects. A multimodal approach has been developed that includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs), intravenous acetaminophen, long-acting local 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.

Pain Addressed During Surgery
Most novel is the use of a new long-acting form of the numbing anesthetic agent bupivacaine. 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 the nausea associated with a spinal block. Peripheral nerve blocks are also being used to help decrease pain in the immediate postoperative period.

Using multiple techniques specifically designed for each individual has greatly improved patient satisfaction and has allowed patients to participate in therapy more quickly and efficiently.

Of course, oral pain pills are also available if and when needed. Understanding how to control your pain postoperatively is important to maximize your outcome. At CRH, we are working on the latest approaches to postsurgical pain management that comes with an excellent hip or knee replacement experience.

Dr. Tannenbaum practices at Southern Indiana Orthopedics, 940 N. Marr Road, Columbus. You can contact him at 812-376-9353.

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