Evaluation of pain levels and pain management in patients after elective total knee replacement surgery

Abstract

Objective: The aim of this study was to evaluate early pain management outcomes in patients undergoing total knee arthroplasty.

Materials and methods: This descriptive cross-sectional study was conducted between 1 March and 30 September 2022. The sample consisted of 112 patients who underwent total knee replacement surgery. Data was collected during face-to-face interviews in the first 24 to 48 hours after surgery, using a patient information form and the revised American Pain Society patient outcome questionnaire (APS-POQ-R). One-way analysis of variance (ANOVA), independent-samples t test, Kruskal-Wallis test and Mann-Whitney test were used in statistical analyses. Ethical approval, institutional approval and written informed consent from the patients were obtained.

Results: The mean age of the patients was 65.11 (±7.108) years, and 92.9 per cent of the patients were female. All patients received combined opioid and nonopioid analgesic and cold application therapy for pain management. In the 24 hours after surgery, the mean mildest pain score was 1.29 (±0.79), the mean most severe pain score was 9.25 (±1.086) and the mean
perceived percentage of time in severe pain was 70.54 per cent (±13.546). The highest emotional effect caused by pain was anxiety with a score of 4.55 (±2.543). The patient level of satisfaction with the results of pain treatment was 8.87 (±1.663) points. It was determined that female patients and patients under 65 years of age had more severe pain and experienced more sleep and emotional effects (p<0.05).

Conclusion: It was observed that patients experienced pain and related anxiety in the early period after total knee arthroplasty. We recommend the use of other nonpharmacological methods along with cold application for effective management of pain and that health professionals should be supported with in-service training in order to better encourage patients.