“One of the things that has greatly improved joint replacement surgery and recovery for patients is the role of pain medication,” explains Carl Deirmengian, MD, orthopedic surgeon with the Rothman Institute at Lankenau Medical Center. “Improvement in the perioperative pain management protocol over the past several years is likely the biggest advance in joint replacement surgery nationally.”
One of these improvements has been the use of multimodal pain relief, says Dr. Deirmengian. A combination of several different pain medications and strategies, a multimodal pain protocol is an approach that allows joint replacement patients a faster rehabilitation, less pain, reduced chance of complication, and an overall more comfortable recovery process. For most patients, intravenous narcotics are no longer necessary to control the pain immediately after surgery.
An Easier Recovery
This multidisciplinary approach to pain management begins even before a joint replacement surgery begins. Prior to surgery, nurses administer a non-narcotic analgesic like Tylenol or Celebrex to help relieve pain. The process continues during surgery, when anesthesiologists provide several medications to avoid pain, and the surgeon injects the surgical site with a variety pain medications. By preempting the pain with proactive methods, controlling the pain after surgery is much more effective.
Within hours after surgery, most patients experience a relatively low level of pain, and are able to begin walking. In the days following surgery, patients can be given a variety of oral medications that minimize pain. By relying on local injections and non-narcotic analgesics, physicians are able to eliminate or lessen the use of intravenous opioids, like morphine or codeine, which have many side effects, but have traditionally been used to alleviate pain post-surgery.
“By using this approach to treatment, we are able to minimize pain, while also minimizing symptoms like nausea, vomiting, and fatigue,” explains Dr. Deirmengian. “We’re making it a better overall experience for the patient. With these multimodal pain management protocols, most patients walk on the day of surgery, and we are hearing far fewer patient complaints of significant pain.”
If you’re scheduled to undergo a joint replacement, talk to your doctor about your options for pain relief. They’ll want to know more about your previous experiences with pain, current medications, history of alcohol and drug use, and answer any questions you have about pain medications to determine what the right method of treatment is for you.