American Society of Anesthesiologists (ASA)
Newswise — Currently affecting 50 million adults in the United States, the pain and disability of arthritis frequently necessitates joint replacement surgery. As the number of Americans affected by arthritis is expected to increase, a new study presented today at the 2008 Annual Meeting of the American Society of Anesthesiologists finds relief for those who undergo the painful orthopedic procedures.
Researchers found that the drug pregabalin, when administered before and after total knee replacement surgery significantly decreased the incidence of chronic pain while increasing and expediting patient mobility after surgery.
“While TKR is an effective surgical treatment one of the complications is chronic pain, a debilitating condition that can lead to a substantial reduction in quality of life with few effective treatment options,” said Asokumar Buvanendran, M.D., associate professor of anesthesiology and director of orthopedic anesthesia at Rush Medical College, Chicago, Illinois. “Searching for ways to improve the patient surgical experience, we evaluated pregabalin for effectiveness not as a treatment for chronic pain, but as a preventative of chronic neuropathic pain after surgery.”
For the trial 240 patients having knee replacement were divided into two groups. Half of the patients received 300 milligrams pregabalin of pregabalin two hours before surgery and repeated doses of 150 milligrams twice a day for 14 days following surgery. The remaining patients received a matching placebo at the same time intervals. After surgery all patients received pain medication through a catheter using a patient controlled epidural device (PCEA).
The principal finding of the study was the dramatic decrease in the incidence of chronic neuropathic pain in patients who received pregabalin. Six months following surgery, 0 percent of patients in the pregabalin group reported the incidence of chronic pain compared to 5.3 percent of patients in the placebo group.
In addition patients that received pregabalin experienced a greater knee range of motion (ROM) following surgery with the ability to perform simple tasks when returning home such as climbing stairs with a ROM of 85 degrees compared to a ROM of 79 degrees for the placebo group. Patients can climb stairs at 83 degrees of knee flexion, descend stairs at 90 degrees and rise from a chair at 90 degrees.
“This is the first large prospective clinical trial examining the incidence of chronic pain after TKR and defining strategy to prevent the development of this debilitating chronic pain syndrome,” said Buvanendran. “With the promising treatment of pregabalin, patients may no longer delay needed orthopedic surgery for fear of pain after surgery and delayed rehabilitation.” More…