Preemptive Tapentadol May Effectively Reduce Pain, Opioid Consumption After TKA

knee replacement surgery
knee replacement surgery
Preemptive tapentadol may safely and effectively reduce postoperative pain in patients undergoing total knee arthroplasty.

The following article is part of conference coverage from the IASP 2018 conference in Boston, Massachusetts. Clinical Pain Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in pain medicine. Check back for the latest news from IASP 2018.

Preemptive tapentadol may safely and effectively reduce postoperative pain in patients undergoing total knee arthroplasty, according to a study to be presented at the 2018 World Congress on Pain, held September 12-16 in Boston, Massachusetts.

Tapentadol is a synthetic μ-opioid receptor agonist and norepinephrine reuptake inhibitor. The study included 75 participants undergoing unilateral total knee arthroplasty who were randomly assigned to receive sustained-release tapentadol 100 mg (n=37) or a matched placebo (n=38) orally 1 hour before spinal anesthesia. Total analgesic consumption, pain intensity (with a visual analog scale and a total pain relief scale), and adverse event profile were evaluated at 0, 2, 4, 6, 12, and 24 hours postsurgery.

At 4 hours postsurgery, the median difference in visual analog scale between the groups was 1.00, 4 hours postsurgery (P =.010); it was 2.00 at 6, 12, and 24 hours postsurgery (P =.001). The total pain relief scale showed similar differences in pain reduction in participants who had received preemptive tapentadol and placebo at 4, 6, 12, and 24 hours (P <.05). During the 24-hour period after surgery, participants who received tapentadol had reduced total analgesic consumption compared with placebo (P =.004). Treatment-emergent adverse event profiles were comparable between the tapentadol and placebo groups.

To best determine what role tapentadol can play in postoperative pain management protocols, the researchers recommend that further studies with larger samples be conducted.

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Hota D, Bhattacharjee S, Srinivasan A, et al. Preemptive tapentadol on post-operative analgesia following total knee arthroplasty: a randomized double-blind placebo-controlled trial (preliminary report). Presented at the World Congress on Pain 2018; September 12-16, 2018; Boston, MA. Poster 63812.

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