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Possible effects of mobilisation on acute post‐operative pain and nociceptive function after total knee arthroplasty
Author(s) -
LUNN T. H.,
KRISTENSEN B. B.,
GAARNLARSEN L.,
KEHLET H.
Publication year - 2012
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2012.02744.x
Subject(s) - medicine , supine position , nociception , anesthesia , analgesic , osteoarthritis , morning , threshold of pain , physical therapy , alternative medicine , receptor , pathology
Background Experimental studies in animals, healthy volunteers, and patients with chronic pain suggest exercise to provide analgesia in several types of pain conditions and after various nociceptive stimuli. To our knowledge, there is no data on the effects of exercise on pain and nociceptive function in surgical patients despite early mobilisation being an important factor to enhance recovery. We therefore investigated possible effects of mobilisation on post‐operative pain and nociceptive function after total knee arthroplasty ( TKA ). Methods Thirty patients undergoing TKA under standardised anaesthesia and analgesia underwent an exercise (mobilisation) strategy on the first post‐operative morning consisting of 25‐m walking twice, with a 20‐min interval. Pain was assessed at rest and during passive hip and knee flexion before, and 5 and 20 min after walk, as well as during walk. Nociceptive function (pain threshold and tolerance) was assessed with pressure algometry and an electrical stimulus. Results Pain at rest (supine) and during hip and knee flexion was significantly reduced 5 min ( P < 0.03) and 20 min ( P < 0.003) after walk compared with before walk, and pain was reduced during the second walk compared with the first walk ( P < 0.034). Knee pain pressure threshold ( P = 0.002) but not tolerance ( P = 0.27) was increased following walk compared with before walk. Conclusion This first exploratory hypothesis‐generating pilot study suggests mobilisation to promote analgesic effects after TKA calling for future studies with a randomised, controlled design on exercise dose–response effects in post‐surgical patients.