AAOS Releases Pain Reduction Guidelines After Orthopedic Surgery

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The American Academy of Orthopedic Surgeons has published clinical practice guidelines and appropriate criteria for use on the suitability of pain relief strategies for reducing pain after orthopedic surgery and traumatic injury.

Developed in collaboration with the Major Extremity Trauma Research Consortium, the Clinical Practice Guideline and Appropriate Use Criteria aim to minimize opioid use in the postoperative period for better patient outcomes. According to a press release, they are intended for use by all qualified and trained providers and surgeons involved in relieving patient pain and improving function after musculoskeletal injury or orthopedic surgery.

The release noted that the clinical practice guideline evaluates 28 therapeutic interventions for pain relief, improved function, and reduction of opioids after musculoskeletal injury or orthopedic surgery to improve care. The highlights of the clinical practice guideline are as follows:

– Moderate evidence that there is no difference in patient outcomes between local and regional anesthesia for patients undergoing total knee and hip arthroplasty;

– Strong evidence for the use of continuous regional anesthesia versus local anesthesia to reduce pain and opioid use in the first 24 hours after total shoulder arthroplasty;

– Strong evidence for the use of IV ketamine in the perioperative period to reduce opioid consumption in the first 24 hours after PTH and PTG; and

– Strong evidence that acetaminophen should be used to improve patient pain and decrease opioid use.

The release also noted that the appropriate use criteria are intended to offer advice on decision factors for adults with musculoskeletal injuries to the extremities and / or pelvis, with treatment scenarios provided based on the recommendations from clinical practice guidelines. The Appropriate Use Criteria online tool provides algorithms on how to optimally assess the condition based on a patient’s various indications, including severity / type of injury, intensity of pain, extent of limitation, intensity of pain, extent of limitation, and degree of energy / polytrauma, depending on version.

“The evidence-based guideline and [appropriate use criteria] AUC tools offer accepted approaches to treatment and / or diagnosis and are not intended to be a fixed protocol, ”the statement said. “Patient care and treatment should always be based on the independent medical judgment of a clinician, taking into account the specific clinical circumstances of each patient. “


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