pre-medication-Royal Devon and Exeter NHS Foundation Trust-postoperative pain

This pre-medication protocol is a standardized pharmacological regimen developed and utilized by the Royal Devon and Exeter NHS Foundation Trust for patients undergoing primary total knee arthroplasty (TKA). The protocol is designed to provide early-stage analgesia and reduce preoperative anxiety as part of a multimodal pain management strategy. The primary mandatory component is 1g of paracetamol, which provides non-opioid analgesia through the inhibition of prostaglandin synthesis. For patients requiring anxiolysis, the protocol includes the administration of benzodiazepines, specifically temazepam (10-20mg) or diazepam (2-5mg), which enhance GABAergic neurotransmission. Additionally, the regimen incorporates gastric protection through the use of antacids such as ranitidine (an H2 receptor antagonist), metoclopramide (a D2 receptor antagonist), or proton pump inhibitors. This specific combination was evaluated in the LIFT clinical trial to establish a baseline for comparing regional anaesthetic techniques.

Other names

Pre-medication (LIFT trial protocol)