Does the standart intravenous patient controlled analgesia dose adequate for patients with bilateral total knee arthroplasty procedure?

Aim: Total knee arthroplasty (TKA) is an orthopedic surgery that can be performed simultaneous bilateral knee procedure or unilateral procedure. Adequate analgesia decreases complications and increases functional recovery. The aim of our study is to investigate whether patients with simultaneuous bilateral knee procedure had different responses to the standart intravenosus patient controlled analgesia (IV-PCA) protocol of our hospital, compared to the patient with unilateral procedure. Material And Method: This study is a retrospective data analysis from patients who underwent simultaneous bilateral and unilateral TKA between January 2014 and December 2017 in Dokuz Eylul University Hospital. Patients were ASA (American Society of Anesthesiologists) physiological status I-III, between 18-99 years old, operated under spinal anaesthesia and used morphine-based PCA in postoperative period. Results: Total of 68 patients with simultaneous bilateral TKA and 124 patients with unilateral TKA were enrolled. Female gender was higher in both groups. Preoperative and total length of hospital stay was higher in unilateral TKA group. During the postoperative 0-24 and 24-48 hours period, in the bilateral TKA group, the analgesic demands, delivery quantities and morphine consumptions were significantly higher than the unilateral TKA group. The side effects of morphine between two groups were similar. VAS scores were higher in the unilateral TKA group between 24-48 hours. Conclusion: As a result of our study, it was shown that opioid-related side effects did not show a significant difference although bilateral TKA patients had higher morphine consumption in postoperative period, and our standard dose IV-PCA protocol was safe and effective in both groups. Anahtar Kelimeler: Total Knee Arthroplasty, Patient Controlled Analgesia, Postoperative Pain