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Abstract
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Background and Aims Total knee arthroplasty surgery is one of the most common orthopedic surgeries performed and are associated with high pain scores and opioid requirements. Novel multimodal pain management is a priority. A gap in the literature exists regarding the effects cryoanalgesia on postoperative opioid consumption. The aim of this study was to determine the effect of cryoanalgesia on opioid consumption by evaluating the number of prescription refills up to 90 days postoperatively.
Methods A retrospective chart review of 103 subjects that received a standard ERAS protocol with peripheral nerve blocks. 45 subjects received cryoanalgesia treatment to three anterior femoral cutaneous and the infrapatellar branch of the saphenous nerves and 58 subjects did not receive cryoanalgesia. Outcomes evaluated were total postoperative opioid prescription refills at days 15, 30, 45, and 90, total morphine milliequivalents, postoperative pain scores between time intervals, and pain scores.
Pain scores
Number of refills
Stats for refills
Results There was not a significant reduction in total postoperative opioid prescription refills or total morphine milliequivalents at any time interval between the groups. There was a significant difference (p<0.001) in refills between days 45 and 90 in the Non-Cryoanalgesia group. There was a statistically significant reduction in the average preoperative pain scores with 0.7 in the cryoanalgesia group and 7.4 in the non-cryoanalgesia group (P<0.001).
Conclusions Preoperative cryoanalgesia treatment does not significantly decrease postoperative opioid consumption, but significantly lowers preoperative pain scores in patients undergoing TKA and refills between 45 and 90 days. This could be an excellent treatment for patients who cannot undergo or the procedure must be delayed for optimization.