Abstract
OBJECTIVE: To determine the efficacy of the Synaptic 2000 in reducing total knee replacement postoperative pain in a prospective randomized controlled trial.DESIGN: Patients were prospectively randomly assigned to two groups, one receiving seven days of transcutaneous electrical stimulation (TES) therapy in addition to standard postoperative care, and the other receiving standard postoperative care. Both groups received postoperative patient‐controlled analgesia and were switched to oral opiates.SETTING: Patients were treated at a university teaching hospital for elective primary unilateral total knee replacement.PATIENTS: All patients consented to enter the study. All had primary osteoarthritis. Fifteen patients were entered into each arm of the study, and all patients completed the study. The mean age of patients was 64 years for treatment and 71 years for controls.OUTCOME MEASURES: Outcome measures were analgesic consumption, return of knee range of motion and score on a visual analogue pain scale.RESULTS: No significant differences were noted in postoperative analgesic use, knee range of motion, length of stay or visual analogue pain scale score. Mean total analgesic use of morphine was 148 mg in the TES group and 108 mg in the control group. The TES group mean knee range of motion on postoperative day 7 was 75.3°; it was 73.6° in the control group. Group mean length of stay was 9.5 days in the TES group and 8.3 days in the control group.
Highlights
As can be seen from the analgesic consumption of the patients summarized in Table 1, for each of the postoperative days 1 through 7, the analgesic requirement for the treatment group was not statistically different from that for the control group
The total analgesic consumption over the first seven days after surgery was the equivalent of 108 mg morphine for the control group and the equivalent of 148 mg morphine for the treatment group
The treatment group was slightly younger in age, which, if anything, might result in a greater range of motion and less analgesic requirement than the control group
Summary
POD Postoperative day PATIENTS AND METHODS A prospective randomized controlled study was designed to test the efficacy of the Synaptic 2000 device for postoperative pain. All patients received intravenous patient-controlled analgesia (PCA) pumps using morphine postoperatively and were converted to oral analgesics as appropriate. The study looked at the effect of the device on pain as measured by analgesic consumption and range of motion in the operated knee.
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