Postoperative orthopaedic pain--the effect of opiate premedication and local anaesthetic blocks.

The postoperative analgesic effect of opiate premedication and local anaesthetic blocks was studied in 929 patients having orthopaedic surgery. The median time to first request for postoperative analgesia was less than 2 h when neither opiate premedication nor block was used; opiate premedication increased the time significantly to more than 5 h; local anaesthetic block produced a further significant increase to 8 h and opiate premedication used with local anaesthetic block extended the median time further to more than 9 h. Women requested analgesia significantly earlier than men, independent of treatment. Age had no significant effect. Prolonging the time before more pain relief is required may be worthwhile for both patients and staff.