Patient-controlled analgesia for total joint arthroplasty.

Pain control following total joint arthroplasty is critical for optimizing patient outcome. Both the real and perceived success of joint arthroplasty surgery depends on the patient's level of pain in the postoperative period. Patients who experience less pain will be more satisfied with their surgery and will be able to more fully participate in postoperative mobilization and rehabilitation. Optimal pain control must be balanced against the adverse effects of narcotics, including alteration of sensorium (especially in older patients) as well as respiratory depression. Modern strategies to control postoperative pain involve a multimodal approach that includes the use of intravenous patient-controlled analgesia.