Postoperative Pain Management in Patients Undergoing Hip Surgeries with Spinal Anesthesia: Review Article

Abstract

Background: There are several pre-, intra-, and post-operative therapies and management options available for minimizing and  controlling postoperative pain. Postoperative pain following total hip arthroplasty (THA) is frequently categorized as moderate to severe.  This can have an impact on the recovery process after surgery, leading to a delay in the ability to move and an extended stay in the  hospital. A very efficient approach for pain relief is required. Historically, the management of this has been accomplished by the  utilization of epidural analgesia, peripheral nerve blocks, and the administration of opioids through injection or directly into the spinal  cord.  Combining multimodal analgesia with nerve block methods is frequently employed to alleviate pain throughout the surgical phase  of hip fractures. This approach has been demonstrated to effectively prevent complications and enhance postoperative function by  ensuring proper pain control.

Objective: This review aimed to assess spinal anesthesia in management of postoperative pain.

Methods:  We searched PubMed and Google Scholar for information on Postoperative pain management, Hip surgeries and Spinal anesthesia.  Although only the most current or comprehensive study from October 2009 to November 2023 was included, the writers additionally  assessed references from pertinent literature. Papers written in languages other than English have been disqualified due to lack of  translation sources.

Conclusion: Peripheral nerve blocks offer efficient pain relief, but to adequately manage pain, it may be required to block the femoral nerve (FN), obturator nerve (ON), and lateral cutaneous nerves (LCN). However, this procedure can be challenging,  time-consuming, and may lead to lingering motor impairment. Spinal and parenteral opioids have a connection with modest but  unpleasant adverse effects.