title: Multimodal acute pain management.
abstract: Unrelieved postoperative pain following arthroplasty has been shown to delay patients' recovery and discharge from the hospital. Undertreatment of acute pain may also result in greater use of healthcare resources and ultimately lead to poor outcomes. This article reviews a multimodal approach to reduce pain at each step of the pain nocioception process by combining various analgesics that each operate through a different site or mechanism of action, allowing the physician to tailor the regimen to the patient. A therapeutic combination of analgesics (eg, opioids, nonsteroidal anti-inflammatory drugs, and bupivicaine) can provide adequate pain relief; however, regional anesthesia is fraught with side effects. The use of multimodal analgesia reduces hospital stay, decreases medical complications, and increases patient satisfaction.
authors.affiliation: Department of Orthopaedic Surgery, University of California, Irvine, Irvine, California, USA.
authors.forename: Harry B
authors.initials: HB
authors.lastname: Skinner
mesh_terms: D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid; D000765:Anesthesia, Conduction; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology / Q000627:therapeutic use; D001178:Arthroplasty; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine; D004359:Drug Therapy, Combination; D006801:Humans; D020910:Ketorolac / Q000494:pharmacology / Q000627:therapeutic use; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002045:Bupivacaine; D020910:Ketorolac