Background and importance In order to improve pain control in patients undergoing arthroplasty, in March 2021 the Pain Management Unit introduced a new protocol that included the use of elastomeric levobupivacaine pumps administred in the adductor canal.
Aim and objectives To evaluate the reduction of postoperative pain and the need for rescue analgesia after the introduction of elastomeric levobupivacaine pumps.
Material and methods Study design: retrospective and quasi-experimental in a 254-bed regional hospital.
Sample: all patients who underwent arthroplasty. Two study groups were established: PRE group (August 2020–February 2021) and POST group (March–September 2021).
Variables: demographic data, anaesthetic risk according to American Society of Anesthesiologists (ASA) visual analogue scale (VAS) pain score at rest on the intervention day (day 0), VAS on day 1 at rest and on movement, and VAS on day 2 (discharge day) at rest and on movement, and need for rescue medication.
Data were obtained from the paper nursing register and the patient’s electronic medical records. The statistical analysis was carried out with SPSS v19 and χ2 or Student’s test were applied according to the type of variable. A p value <0.05 was considered statistically significant.
Results Ninety-three patients, 36 (38.7%) men; age 72 (7) years. Anaesthetic risk: 1 (1.1%) patient ASA I, 74 (80.4%) ASA II and 17 (18.5%) ASA III. PRE group, 39 (41.9%) and POST group 54 (58.1%). No statistically significant differences were observed among groups.
PRE vs POST group: VAS at rest on day 0, 3.7 (2.9) vs 1.9 (1.8) (p<0.001), VAS at rest on day 1, 3.3 (1.6) vs 2.3 (1.1) and 6.4 (1.4) and 3.8 (1.6) on movement (p<0.001) and VAS at rest on day 2, 2.7 (1.6) vs 2.0 (1.3) and 5.2 (1.3) vs 3.7 (1.5) on movement (p<0.025).
Use of rescue medication: day 0, 9 (23.1%) patients in PRE group and 9 (16.7%) in POST group; day 1, 7 (17.9%) in PRE and 6 (11.1%) in POST and day 2, 2 (5.13%) in PRE and 3 (5.56%) in POST (p>0.05).
Conclusion and relevance Better pain control can be appreciated with the introduction of levobupivacaine pumps; however, no statistically significant differences in the use of rescue analgesic medication between groups have been observed.
It is unknown whether the functional recovery of these patients would be affected, an interesting topic for future studies.
Conflict of interest No conflict of interest