Patient education for better pain control in hip replacement by integrating anaesthesia and orthopaedic strategies
Keywords:
Hip Replacement, Patient Education, Postoperative Pain, Opioid Consumption, Patient SatisfactionAbstract
Background: Postoperative pain management remains a significant challenge for patients undergoing hip replacement surgery. This study investigated the effectiveness of a comprehensive patient education program in reducing postoperative pain, opioid consumption, and length of hospital stay, as well as improving patient satisfaction.
Methods: A randomized controlled trial was conducted at a tertiary care hospital. A total of 154 patients undergoing primary hip replacement surgery were randomly allocated to either the intervention group (n=77), which received a comprehensive patient education program, or the control group (n=77), which received standard care. Pain scores, opioid consumption, patient satisfaction, and length of hospital stay were assessed at various time points.
Results: The intervention group demonstrated significantly lower pain scores and opioid consumption at 24, 48, and 72 hours post-surgery compared to the control group (p<0.001). Patient satisfaction scores were significantly higher in the intervention group (4.2 ± 0.7 vs. 3.6 ± 0.9, p=0.001). The length of hospital stay was significantly shorter in the intervention group (3.9 ± 1.1 days vs. 4.5 ± 1.2 days, p=0.0023). Logistic regression analysis revealed that the intervention group had a significantly higher odds of achieving high patient satisfaction (OR=2.45, 95% CI: 1.32-4.56, p=0.004), independent of age and gender.
Conclusion: A comprehensive patient education program significantly reduced postoperative pain, opioid consumption, and length of hospital stay while improving patient satisfaction in patients undergoing hip replacement surgery. These findings highlight the importance of incorporating patient education into the standard of care for hip replacement patients to optimize outcomes and enhance the quality of care.
References
Heikkinen, K., Kauppila, T., & Turunen, H. (2008). The effects of a multidisciplinary education program on pain and functional outcomes in hip replacement patients. Journal of Orthopaedic Nursing, 12(3), 123-129.
Johansson, K., Nuutila, L., Virtanen, H., Katajisto, J., & Salanterä, S. (2005). Preoperative education for orthopaedic patients: Systematic review. Journal of Advanced Nursing, 50(2), 212-223.
Wang, Y., Li, J., & Zhou, Y. (2010). Long-term effects of preoperative education on pain and quality of life in patients undergoing total hip replacement. Patient Education and Counseling, 80(3), 393-397.
McDonald, S., Page, M. J., Beringer, K., Wasiak, J., & Sprowson, A. (2014). Preoperative education for hip or knee replacement. Cochrane Database of Systematic Reviews, (5), CD003526. https://doi.org/10.1002/14651858.CD003526.pub3.
Louw, A., Diener, I., Butler, D. S., & Puentedura, E. J. (2013). Preoperative education addressing postoperative pain in total joint arthroplasty: Review of content and educational delivery methods. Physiotherapy Theory and Practice, 29(3), 175-194. https://doi.org/10.3109/09593985.2012.727527.
Jones, S., Alnaib, M., Kokkinakis, M., Wilkinson, M., St Clair Gibson, A., & Kader, D. (2011). Pre-operative patient education reduces length of stay after knee joint arthroplasty. Annals of the Royal College of Surgeons of England, 93(1), 71-75. https://doi.org/10.1308/003588410X12771863936765.
Kearney, M., Jennrich, M. K., Lyons, S., Robinson, R., & Berger, B. (2011). Effects of preoperative education on patient outcomes after joint replacement surgery. Orthopaedic Nursing, 30(6), 391-396. https://doi.org/10.1097/NOR.0b013e31823710ea.
Johansson, K., Nuutila, L., Virtanen, H., Katajisto, J., & Salanterä, S. (2005). Preoperative education for orthopaedic patients: Systematic review. Journal of Advanced Nursing, 50(2), 212-223. https://doi.org/10.1111/j.1365-2648.2005.03381.x
Yoon, R. S., Nellans, K. W., Geller, J. A., Kim, A. D., Jacobs, M. R., & Macaulay, W. (2010). Patient education before hip or knee arthroplasty lowers length of stay. The Journal of Arthroplasty, 25(4), 547-551. https://doi.org/10.1016/j.arth.2009.03.012
Chen, S. R., Chen, C. S., & Lin, P. C. (2014). The effect of educational intervention on the pain and rehabilitation performance of patients who undergo a total knee replacement. Journal of Clinical Nursing, 23(1-2), 279-287. https://doi.org/10.1111/jocn.12466
Huang, S. W., Chen, P. H., & Chou, Y. H. (2012). Effects of a preoperative simplified home rehabilitation education program on length of stay of total knee arthroplasty patients. Orthopaedics & Traumatology: Surgery & Research, 98(3), 259-264. https://doi.org/10.1016/j.otsr.2011.12.004
Ibrahim, M. S., Alazzawi, S., Nizam, I., & Haddad, F. S. (2013). An evidence-based review of enhanced recovery interventions in knee replacement surgery. Annals of the Royal College of Surgeons of England, 95(6), 386-389. https://doi.org/10.1308/003588413X13629960046435
Johansson, K., Nuutila, L., Virtanen, H., Katajisto, J., & Salanterä, S. (2005). Preoperative education for orthopaedic patients: Systematic review. Journal of Advanced Nursing, 50(2), 212-223. https://doi.org/10.1111/j.1365-2648.2005.03381.x
Jones, S., Alnaib, M., Kokkinakis, M., Wilkinson, M., St Clair Gibson, A., & Kader, D. (2011). Pre-operative patient education reduces length of stay after knee joint arthroplasty. Annals of the Royal College of Surgeons of England, 93(1), 71-75. https://doi.org/10.1308/003588410X12771863936765
Kearney, M., Jennrich, M. K., Lyons, S., Robinson, R., & Berger, B. (2011). Effects of preoperative education on patient outcomes after joint replacement surgery. Orthopaedic Nursing, 30(6), 391-396. https://doi.org/10.1097/NOR.0b013e31823710ea
Lin, P. C., Lin, L. C., & Lin, J. J. (2013). Comparing the effectiveness of different educational programs for patients with total knee arthroplasty. Orthopaedic Nursing, 16(5), 716-721. https://doi.org/10.1097/00006416-199709000-00005
Louw, A., Diener, I., Butler, D. S., & Puentedura, E. J. (2013). Preoperative education addressing postoperative pain in total joint arthroplasty: Review of content and educational delivery methods. Physiotherapy Theory and Practice, 29(3), 175-194. https://doi.org/10.3109/09593985.2012.727527
McDonald, S., Page, M. J., Beringer, K., Wasiak, J., & Sprowson, A. (2014). Preoperative education for hip or knee replacement. Cochrane Database of Systematic Reviews, (5), CD003526. https://doi.org/10.1002/14651858.CD003526.pub3
Moulton, L. S., Evans, P. A., Starks, I., & Smith, T. (2015). Pre-operative education prior to total hip arthroplasty improves postoperative pain and function: A randomized controlled trial. International Journal of Surgery, 21, 24-29. https://doi.org/10.1016/j.ijsu.2015.06.044
Yoon, R. S., Nellans, K. W., Geller, J. A., Kim, A. D., Jacobs, M. R., & Macaulay, W. (2010). Patient education before hip or knee arthroplasty lowers length of stay. The Journal of Arthroplasty, 25(4), 547-551. https://doi.org/10.1016/j.arth.2009.03.012