Factors Associated with Early Postoperative Pain after Total Knee Arthroplasty

Sasikaan Nimmaanrat; Thara Tantichamnankul; Mark P. Jensen; Sirikarn Siripruekpong; Sumidtra Prathep; Khanin Iamthanaporn

doi:10.31584/jhsmr.20251266

Factors Associated with Early Postoperative Pain after Total Knee Arthroplasty

Sasikaan Nimmaanrat, Thara Tantichamnankul, Mark P. Jensen, Sirikarn Siripruekpong, Sumidtra Prathep, Khanin Iamthanaporn

Abstract

Objective: Total knee arthroplasty (TKA) is a common operation for geriatric patients. Knowing the factors leading to acute post-TKA pain will lead to personalized pain care.
Material and Methods: We recruited 843 patients who underwent TKA. Preoperative, intraoperative, and postoperative data were obtained retrospectively.
Results: Moderate to severe postoperative pain in the first 24 hours was found in 87%. Factors associated with moderate to severe postoperative pain were being female [adjusted odd ratio (AOR) 2.34, 95% confidence interval (95% CI) 1.23-4.46], having an ASA physical status classification of II (AOR 9.22, 95% CI 1.9-44.67) or III (AOR 6.75, 95% CI 1.32-34.63), a longer tourniquet time (AOR 1.01, 95% CI 1.01-1.02), and postoperative use of aspirin (AOR 2.04, 95% CI 1.25-3.32). Factors found to be associated with mild postoperative pain were being younger (AOR 0.97, 95% CI 0.94-0.99), being given intrathecal fentanyl (AOR 0.3, 95% CI 0.12-0.73), having a peripheral nerve block (AOR 0.28, 95% CI 0.12-0.66), and taking a systemic corticosteroid (AOR 0.26, 95% CI 0.13-0.55), parecoxib (AOR 0.39, 95% CI 0.19-0.78) or ketorolac (AOR 0.47, 95% CI 0.23-0.99).
Conclusion: Being female, having an ASA physical status classification of II or III, a longer tourniquet time, and postoperative use of aspirin were significantly related to having moderate to severe postoperative pain within the first 24 hours after TKA. Factors associated with mild postoperative pain included being younger, intrathecal fentanyl, having a peripheral nerve block, receiving a systemic corticosteroid, and use of parecoxib and ketorolac.

Keywords

associated factors; postoperative pain; total knee arthroplasty

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DOI: http://dx.doi.org/10.31584/jhsmr.20251266

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