Advancements in pain management have made post-operative joint replacement considerably less uncomfortable than as recently as three years ago. It's a significant milestone in joint replacement post-operative care because the presence or absence of pain not only changes the way patients feel; it can impact the long-term success of the prosthetic joint.
According to Roger Raichelson, M.D., Director of the Anesthesia Department at Nyack Hospital, pain can increase length of stay in the hospital, hinder a patient's motivation and the ability to tolerate rehabilitation, and affect the degree of mobility the patient is able to ultimately achieve.
However, these concerns are rapidly diminishing with the advent of a single 48-hour timed-release of the narcotic pain reliever, Depodur. *So for the first two days post-op, when pain is at its maximum, we can minimize what a patient actually experiences both at rest, and while they're in motion,* explains Dr. Raichelson. *Patients used to see the rehabilitation doctors coming and wince at the thought of having to do physical therapy. Now that's much less the issue. Newer pain modalities also include the use of a continuous femoral nerve catheter that minimizes discomfort and allows for early mobility after knee replacement.*
Since the Joint Replacement Center first used the 48-hour timed-release method of pain relief last year, patients have been able to get out of bed and start physical therapy sooner, regain their mobility and leave the hospital earlier (usually after three days). Furthermore, the doctor points out, “when pain pathways are blocked before they're formed, the total amount of pain people experience is reduced. Even after discharge, they actually feel less pain.” He says orthopedic surgeons are “ecstatic” about 48-hour timed-release pain management because “the earlier patients get moving, the greater range of motion they will achieve down the line.”
In use for less than two years, the method is similar to the so-called “walking epidural” administered to women in labor, but it is longer acting. It doesn't produce numbness and alleviates the need for intravenous narcotics that can cause sleepiness and confusion. And although 48-hour pain relief rarely causes minor side effects, including itching and nausea, Dr. Raichelson says patients receive medicines that minimize these.
