Preemptive Analgesia in Total Knee Arthroplasty

Fakultas Kedokteran Universitas Indonesia30 enrolled

Overview

Acute Pain is the most common early complication after total knee arthroplasty that caused delayed mobilization, demands of morphine, and higher operative cost. There were many researches that had been done in analgesia method to find the most effective analgesia, lowest side effect, and easy to apply. Preemptive analgesia of combined celecoxib and pregabalin were reported to give a promising outcome. In a randomized, double blind controlled clinical trial, 30 subjects underwent surgery for total knee arthroplasty using 15-20mg bupivacaine 5% epidural anesthesia. All subjects were divided into three groups. First group was given celecoxib 400mg and pregabaline 150mg 1 hour before operation, second group was given celecoxib 200mg and pregabaline 75mg twice daily started from 3 days before operation, and the last group was given placebo. The outcome was measured with VAS, knee ROM, and post-operative mobilization

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Acute Pain

Interventions

Eligibility

Sex: ALLMin age: 55 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * 55-80 years old patients who come to orthopaedic polyclinic * underwent TKA procedure * have osteoarthritis * consumed pain killer and anti inflamatory drugs routinely Exclusion Criteria: * psychiatric disorder * have history of renal disease * histroy of chronic neurophatic * have genu arthritis that caused by rheumatid arthritis and infection * diabetic and obesity * coagulopathy * patients with severe pain that needed immediate analgesia regimen

Outcomes

Primary Outcomes

Total Morphine Consumption

In this study, morphine is given by patient control analgesia (PCA).

Time frame: Third day post-operative

Secondary Outcomes

Post-operative Pain

Measured and evaluated by Visual Analogue Scale (VAS). VAS score of 1-10. With the maximal of 10. Ranging from no pain to unbearable pain. Worst pain is in score 10.

Time frame: every morning [daily], up to 3 days

Knee functional outcome

Measured by active knee range of motion using goniometer. The outcome scale is in degree range of motion. The knee range of motion is 0 degree (total extension) to 135 degree (full flexion). The more range of motion degree, the better the result.

Time frame: every morning [daily], up to 3 days

Mobilization

The patient is expected to be able to do sitting motion

Time frame: on the first day, standing on the second day, and walking on the third day