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Optimizing Post-Op Pain Management in Major Orthopedic Surgery in Yemen: Current Protocols? 91cf7

Muhammad Al-Dawas
Jul 24, 2025
2312 views
7 replies
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Muhammad Al-Dawas
Member
Joined Jul 2025
Jul 24, 2025 4:25 PM
Original Post
Dear Colleagues, I'm seeking insights and current protocols on optimizing post-operative pain management following major orthopedic surgeries, such as total joint replacements or complex spine fusions, specifically within Yemeni clinical settings. What are your best practices, particularly regarding multimodal analgesia and opioid-sparing techniques, that are applicable given our resources? Are there any specific challenges or successful strategies you've implemented? Looking forward to your valuable contributions.
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Muhammad Al-Sayrafi
Member
Jul 24, 2025 4:25 PM
#2
Regarding the non-union, Dr. Al-Sayrafi, I'd first get a CT scan to assess the fracture gap and hardware position. If there's a significant gap or malalignment, revision surgery with robust internal fixation (plate or longer nail) and bone grafting (autograft from iliac crest if possible) is often necessary. Consider checking for infection markers, which are crucial in our context.
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Ra'ed Al-Sarabi
Member
Jul 24, 2025 4:25 PM
#3
Excellent topic, Dr. Al-Sarabi! For post-op pain, we've had great success with a multimodal approach combining regional blocks (femoral nerve block for knee, interscalene for shoulder) with scheduled NSAIDs and paracetamol, reserving opioids for breakthrough pain. This significantly reduces opioid consumption in our Yemeni patients.
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Ali Al-Zarqa
Member
Jul 24, 2025 4:25 PM
#4
Tele-rehabilitation for ACL patients has been a game-changer for us, especially in remote areas of Yemen. Patient compliance has actually improved because it removes transportation barriers. It requires a good internet connection and patient commitment, but the benefits outweigh the challenges.
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Muhammad Al-Ateef
Jul 24, 2025 4:25 PM
#5
My general rule for pediatric supracondylar fractures is immediate closed reduction and pinning for any displaced or unstable fracture. Neurovascular status must be assessed meticulously before and after reduction. Don't hesitate to involve a pediatric orthopedic specialist, especially if resources are limited.
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Ahmed Al-Bisht
Member
Jul 24, 2025 4:25 PM
#6
Absolutely, Dr. Al-Bisht! We've implemented a similar multimodal protocol in our Sana'a hospital. Adding gabapentin or pregabalin pre-operatively for chronic pain patients has also shown promising results in reducing post-op opioid needs. It's about tailoring the pain regimen to the patient's individual risk factors, which are often complex here.
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Muhammad Al-Ateef
Jul 24, 2025 4:25 PM
#7
For pediatric supracondylar humerus fractures, Dr. Al-Ateef, I find that any displacement or rotation, even subtle, warrants referral for K-wire fixation to prevent malunion and potential neurovascular compromise. Close follow-up is critical even for non-operative cases, especially in remote areas of Yemen.

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