Term of Award

Spring 1996

Degree Name

Master of Science in Nursing

Document Type and Release Option

Thesis (restricted to Georgia Southern)

Committee Chair

June Alberto

Committee Member 1

Sara Connor

Committee Member 2

Kaye Herth

Abstract

The provision of adequate and appropriate pain management is paramount as pain impacts every aspect of the person's quality of life. Pain is a common symptom and phenomenon that is frequently seen and observed among orthopedic patients. Numerous advanced pain relief techniques such as epidural analgesia have been introduced and utilized over the years. However, inadequate and inappropriate pain management continues to be a significant problem for postoperative orthopedic patients such as the post total knee replacement (TKR).

In a study conducted by Slack & Faut-Callahan (1990), it was revealed that although various techniques and new drugs have evolved as alternatives for pain control, most patients continue to receive intramuscular or intravenous injections of narcotics for moderate to severe postoperative pain. Therefore, the purpose of this study was to investigate the efficacies of epidural algesia in pain relief and time of mobility versus conventional analgesia among post TKR patients.

The theoretical framework utilized for this study was the gate control theory. This theory postulates that the provision of exact information about the cause and relief of pain, a sense of control, or a decrease in fear and anxiety may alleviate pain. The literature review identified studies that support the efficacies of epidural analgesia in many areas of medicine especially in postoperative pain of joint replacement patients.

A prospective, quantitative research design was utilized to compare the effectiveness in pain relief and time of mobility between post TKR patients on epidural analgesia and those on conventional analgesia. The convenience sample was comprised of 16 post TKR patients from two tertiary hospitals. The visual analog pain scale was utilized to measure the pain intensity of the patients during the first three postoperative days. Time of mobility was measured as the earliest postoperative day of ambulation and use of the continuous passive motion (CRM) knee exerciser.

The results of the study indicated that there was no statistically significant differences that exist between the epidural and conventional groups of post TKR patients in relation to pain relief. Likewise, there was no statistically significant difference in time of mobility between the two groups. Limitations of the study included the small convenience sample and wide age range of subjects. Further research with a large random sample and narrow age range of subjects is strongly recommended. Moreover, further study that considers the time in measuring pain intensity and the patient's accompanying activities is recommended.

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