| DOI: https://doi.org/10.14456/mujps.2015.19 | Pharm Sci Asia 2015; 42(4), 153-161 |
Efficacy of multimodal pain management in patients undergoing hip replacement in a Vietnamese hospitalTT. Nguyen1, TT. Vo2, TH. Bui1*
1 Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
2 Department of Orthopedic Surgery, Thong Nhat Hospital, Ho Chi Minh City, Vietnam
An effective pain relief after hip replacement is necessary to ensure an expected surgery outcome. Multimodal pain management has been recently applied at Thong Nhat hospital, Vietnam. The objectives of this study were to evaluate the effectiveness of multimodal regimen, compared with conventional regimen in patients undergoing hip replacement. A retrospective cohort study was conducted by using medical records of patients undergoing hip replacement. Patients with renal failure and a history of drug addiction or allergy to any study medications were excluded. Patients were randomized into two groups – conventional pain control and multimodal pain control (n = 40 each group). Multimodal pain regimen included intravenous paracetamol 1-2 hours before surgery, spinal anesthesia during surgery and at least two analgesic drugs after surgery. Pre-operative intravenous paracetamol was not performed in the conventional group. There were no significant differences between two study groups with respect to baseline characteristics. Patients in multimodal pain control group had a significantly lower rate of severe pain in the first 3 days after surgery (p ? 0.001), a significantly lower rate of sleep disturbance (p = 0.003), significantly earlier ambulation (p = 0.001), and a significantly lower average dose of used opioid (p = 0.023), compared with those in conventional group. There were no significant differences in hospital stay and adverse event rates (p > 0.05). The multimodal analgesic regimen provided an effective pain relief, an earlier functional recovery as well as decreased opioid consumption.
Keyword:
Multimodal pain management, hip replacement, VAS, surgery.
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