More is better than less analgesic after total knee replacement in geriatric patient. Is it a myth?

Purpose: This study aims to assess the effectiveness of mono pharmacy and polypharmacy on the post-TKR outcome, the speed of recovery, time to partial weight-bearing, VAS, and the side effects of single, double, and triple analgesia in elderly TKR patients. Methods: This observational retrospective comparative study comparing the post-TKR surgical outcome and using mono pharmacy or polypharmacy analgesics was conducted in an Orthopaedic Hospital during 2012-2021. Patients who underwent TKR with a subarachnoid spinal block were diagnosed with osteoarthritis grade IV and treated with single/ unilateral TKR were included in this study. Data would be analyzed using either ANOVA or Kruskal Walis. Treatment of analgesia was given by the anesthesiologist, who determined the types and methods of administration. Results: A total of 152 patients were included in this study. Most samples were females (N=106, 69.7%) aged 63.75 ± 6.31 years. There was no significant difference between analgetic use on LOS, time to PWB, and VAS on days 1, 3, and 5 (p > 0.05). A significant linear difference was found between nausea and gastric pain incidence with the amount of postoperative analgetic administration (p = 0.01). Conclusion: The effectiveness of mono pharmacy and polypharmacy is similar regarding the speed of recovery, time to partial weight-bearing, VAS, and side effects of post-TKR patients.