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ACUTE AND CHRONIC PAIN SYNDROME AFTER TOTAL HIP AND KNEE REPLACEMENT


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Abstract

After joint replacement 25-50% patients suffer from acute pain. Average pain intensity is 5,3 points after total hip replacement (THR) and 6,6 points after total knee replacement (TKR) via 10-points visual assessment scale on the 1st postoperative day. The risk of chronic postsurgical pain syndrome (CPSP) about 5-27% after THR and 8-44% after TKR. Prolonged joint pain before the operation, general anesthesia, severe acute postoperative pain are the risk factors of CPSP. Multimodal analgesia is a basic acute pain management. Use of ketamine (low dosage) and gabapentinoids (gabapentin and pregabalin) decreases the risk of CPSP. Different variants of regional analgesia show promise, but further research is needed.


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