Orthopaedic nursing
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Orthopaedic nursing · Jul 2014
Comparative StudyThe traditional method of oral as-needed pain medication delivery compared to an oral patient-controlled analgesia device following total knee arthroplasty.
As-needed (PRN) oral pain medication is an essential part of multimodal pain therapy. Medication delivery is often delayed because of multiple demands upon nursing time in a busy postoperative nursing unit. Postoperative pain control was compared using either the manual delivery of PRN oral pain medication or a bedside oral patient-controlled analgesia device. ⋯ Device patients had significantly better pain scores than the usual care group on postoperative Day 2 and within the last 24 hours prior to discharge. The device group reported statistically less pain interference overall with general activity, mood, physical therapy, sleep, and appetite. Use of an oral patient-controlled analgesia device may improve pain management and patient function following total knee arthroplasty compared to the traditional delivery of oral PRN pain medication.
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Postoperative confusion is a common complication in older adults, particularly after total joint replacement (arthroplasty). Confusion after surgery can result in slower mobility progression, longer hospital stay, and increased patient distress. Postoperative pain has been shown to be a risk factor related to confusion; however, there is limited evidence regarding pain level, medication use, and confusion development in postoperative arthroplasty patients. ⋯ Patients receiving lower amounts of opioids in the first 48 hours after surgery were more likely to be confused on POD 1(p = .023) and POD 2 (p = .049).