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| Author | Comment |
drena taylor
 Oct 9, 07 - 12:27 PM |
post op management of TKR
Does any one offer an epidrual sevice for post op for Total Knee Replacements (TKR)if so - 1. how long do you keep the epidurals running post op 2. Do you use PCEA 3. How do you manage a lower limb motor block with regards to mobilization 4. Are the patients nursed on the General orthopaedic ward's. 5 what are your pain scores on movement on day 1-3 |
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Jayne Grant
Oct 9th, 2007 - 2:43 PM |
Re: post op management of TKR
We use epidural infusions for 24 hours only, after this period we start our patients on a reducing dose of Oxycontin and Oxynorm for a maximum of 5 days. This regime was found to be really effective and since its introduction has reduced our patients length of stay by 2-3 days. 
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drena taylor
Oct 9th, 2007 - 3:01 PM |
Re: post op management of TKR
hi we tried oxycontin 20mgs BD but found that patients had increased rate of nausea which hindered thier mobilization at present we aim for home on day 5 |
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Ros
Oct 10th, 2007 - 3:55 PM |
Re: post op management of TKR
Hi Drena, We have used epidurals on orthopaedic wards for TKR for a good few years. They have always traditionally been discontinued at 48 hours and have given very good pain relief. However a lot of anaesthetists are using Fem/Sciatic nerve blocks with good effect but some of these cause as much motor block and some patients still find early mobilisation difficult. |
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Sarah
Oct 15th, 2007 - 4:02 PM |
Re: post op management of TKR
Hi We do not use epidural for any of our TKR. Some patients may have a PCA others not. If the patient has had a spinal we use oxynorm on the day of surgery then commence 10mg oxycontin BD day one post op. They can continue having oxynorm PRN also if required. I find that PCA is not used very much and always gets stopped the morning after surgery as most patients can eat and drink therefore oral analgesia can be just as effective. |
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