Updates on Multimodal Analgesia for Orthopedic Surgery.

Darsi N Pitchon, Amir C Dayan, Eric S Schwenk, Jaime L Baratta, Eugene R Viscusi

Journal: Anesthesiology clinics 2018;36(3):361-373

PMID: 30092934

Full Text on Elsevier Science View on PubMed

Abstract

Pain control after orthopedic surgery is challenging. A multimodal approach provides superior analgesia with fewer side effects compared with opioids alone. This approach is particularly useful in light of the current opioid epidemic in the United States. Several new nonopioid agents have emerged into the market in recent years. New agents included in this review are intravenous acetaminophen, intranasal ketorolac, and newer nonsteroidal anti-inflammatory drugs, and the established medications ketamine and gabapentinoids. This article evaluates the evidence supporting these drugs in a multimodal context, including a brief discussion of cost.

Address: Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Suite 8290, Gibbon Building, 111 South 11th Street, Philadelphia, PA 19107, USA. Electronic address: [email protected].; Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Suite 8290, Gibbon Building, 111 South 11th Street, Philadelphia, PA 19107, USA.

DOI: 10.1016/j.anclin.2018.05.001

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MeSH Terms: Acetaminophen, Amines, Analgesia, Celecoxib, Cyclohexanecarboxylic Acids, Gabapentin, Humans, Ibuprofen, Ketamine, Ketorolac, Orthopedic Procedures, Pain, Postoperative, gamma-Aminobutyric Acid