Introduction
Effective postoperative pain control is essential for optimizing recovery following major orthopedic procedures. While systemic opioids remain a widely used analgesic modality, they are associated with significant adverse effects and risk of dependency. Regional anaesthesia (RA) offers a potential alternative with fewer systemic complications. This study aimed to compare the efficacy and safety of RA versus systemic opioids for postoperative pain management in orthopedic surgery.
Methods
A prospective randomized controlled trial was conducted from January to December 2023, involving 100 patients undergoing elective hip, knee, or spine surgery. Participants were randomly allocated into two groups: Group A received regional anaesthesia (spinal, epidural, or peripheral nerve blocks), and Group B received systemic opioids (morphine or oxycodone via PCA). Pain intensity (VAS), opioid consumption, adverse effects, functional recovery, and patient satisfaction were measured over 48 hours. Statistical significance was set at p < 0.05.
Results
RA significantly reduced postoperative pain scores at 12, 24, and 48 hours (p < 0.001), with lower total opioid consumption (17 ± 6 mg vs 44 ± 9 mg, p < 0.001). The RA group experienced fewer side effects including nausea (10% vs 32%) and constipation (8% vs 22%). Functional scores and time to mobilization were significantly better in the RA group. Patient satisfaction was higher in the RA group (4.7 vs 3.8, p < 0.001), while hospital stay duration showed no significant difference.
Conclusion
Regional anaesthesia provides superior pain control, fewer complications, and improved recovery outcomes compared to systemic opioids in orthopaedic surgery, and should be considered the preferred analgesic modality.
Authors
Naveen Bose J
Barts Health NHS Trust, London, United Kingdom
Kaushik Rajavel
Madras Medical College, Chennai, India
Rakshana Munusamy
Kings College Hospital NHS Trust, London, United Kingdom
Priyadarshini Ramesh
Madras Medical College, Chennai, India