A lecture for orthopedic residents and fellows. Here I review some of the data on total knee replacement pain protocols, including blocks and opioid sparing multi-modal pain protocols. This is a shortened version of a talk I gave on this topic a few years ago.
0:00 Introduction
0:26 The New York Times
0:41 Editorial JBJS
1:06 Uncontrolled Postoperative Pain
2:12 Preoperative Pain Management
3:14 Nonpharmacologic Interventions
4:14 Preemptive Analgesia is NOT New
4:49 Definition
5:27 Chronic Opioid Use Prior to TKA
6:26 Peri-operative Pain Management
6:45 Epidural: Gold Standard no more?
7:12 Complications of Nerve Blocks
7:41 Our Experience
9:42 Periarticular Multimodal Injection
10:09 Medications
10:34 Pain Controlled with Narcotics
10:56 Effect of Ketorolac on bleeding and requirements for analgesia after TKA
11:09 IV Ketorolac after THA & TKA
11:19 Celebrex
11:27 Meta-analysis of Cox-2
11:35 Effect of Dexamethasone on postoperative emesis and pain
12:09 Effects of mobilization on acute post- op pain after TKA
12:46 Pain Committee Goals
13:12 Multimodality Philosophy
14:12 My Current Protocol
