(1) Background: The management of postoperative pain after knee replacement is an important clinical problem. The best results in the treatment of postoperative pain are obtained using multimodal therapy principles. Intrathecal morphine (ITM) and single-shot femoral nerve block (SSFNB) are practiced in the treatment of postoperative pain after knee replacement, with the most optimal methods still under debate. The aim of this study was to compare the analgesic efficacy with special consideration of selected side effects of both methods. (2) Materials and methods: Fifty-two consecutive patients undergoing knee arthroplasty surgery at the Department of Orthopedics and Traumatology of the Medical University of Warsaw were included in the study. Patients were randomly allocated to one of two groups. In the ITM group, 100 micrograms of intrathecal morphine were used, and in the SSFNB group, a femoral nerve block in the distal femoral triangle was used as postoperative analgesia. The other elements of anesthesia and surgery did not differ between the groups. (3) Results: The total dose of morphine administered in the postoperative period and the effectiveness of pain management did not differ significantly between the groups (cumulative median morphine dose in 24 h in the ITM group 31 mg vs. SSFNB group 29 mg). The incidence of nausea and pruritus in the postoperative period differed significantly in favor of patients treated with a femoral nerve block. (4) Conclusions: Although intrathecal administration of morphine is similarly effective in the treatment of pain after knee replacement surgery as a single femoral triangle nerve block, it is associated with a higher incidence of cumbersome side effects, primarily nausea and pruritus.

Introduction: Neuropathic pain (NP) arises as a direct consequence of a lesion or disease affecting the somatosensory nervous system. Antidepressants (ADs) are recommended for the pharmacological treatment of NP. However, current guidelines do not specify how long ADs may be effective in NP treatment if the patient is benefiting from the therapy.Material and methods: This was a retrospective cross-sectional study aiming to analyze the effectiveness of ADs in the treatment of NP by assessing the relationship between AD usage, the length of AD treatment and the intensity of pain in this group patients. Based on their pain intensity and length of treatment, the patients were divided into: three groups (NRS 0–3, NRS 4–6 and NRS ≥ 7), and six groups (< 1 month, 1–3 months, 3–6 months, 6–12 months, 1–2 years, 2–5 years, and > 5 years), respectively.Results: The study was conducted on a database from 421 patients, 231 (54.86%) of whom took antidepressants. We found that AD treatment significantly reduces the likelihood of being in the NRS 7–10 group compared to the NRS 0–3 group (OR = 0.611, 95% CI: 0.37–1.0, P = 0.05), and this reduction was observed up to 24 months of treatment (OR = 0.41, 95% CI: 0.22–0.75, P < 0.004).Conclusions: Considering the limitations of the study, the use of ADs in NP therapy may have a significant impact on reducing the occurrence of severe pain up to 24 months of therapy and should be included in pharmacotherapy in this group of patients.