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  1. Napier, Deborah E. MA, BSN, RN
  2. Bass, Samuel S. BA, ADN, RN, CPAN


PURPOSE: The purpose of the study was to compare postoperative outcomes in patients undergoing total knee replacement via general anesthesia with patients receiving an intrathecal injection for anesthesia.


DESIGN: A two-group comparison design was selected to differentiate pain control, ambulation distance, and length of hospital stay in total knee arthroplasty patients.


SAMPLE: A random sample of 85 patients receiving a total knee arthroplasty by the same surgeon were selected. Forty-four patients received general anesthesia, and 41 patients received an intrathecal injection.


FINDINGS: The overall effect of pain control was greater in patients with intrathecal injections up to 48 hours after arrival on the orthopedic unit. Ambulation distance was greater for intrathecal patients for the first three therapy sessions.


IMPLICATIONS FOR NURSING PRACTICE: The use of an intrathecal injection for pain management changes postoperative nursing care planning and interventions. Improved pain control results in more alert and responsive patients and earlier ambulation. Patient teaching for prevention of complications and self-care postdischarge can begin earlier.