title: Multimodal pain management after total joint arthroplasty.
abstract: Adequate postoperative pain control in patients who have undergone total joint arthroplasty allows faster rehabilitation and reduces the rate of postoperative complications. Multimodal pain management involves the introduction of adjunctive pain control methods in an attempt to control pain with less reliance on opioids and fewer side effects. Current research suggests that traditional nonsteroidal anti-inflammatory drugs (NSAIDs) and the associated cyclooxygenase type-2 (COX-2) inhibitors improve pain control in most cases. Nearly all multimodal pain management modalities have a safe side-effect profile when they are added to existing methods. The exception is the administration of DepoDur (extended-release epidural morphine) to elderly or respiratory-compromised patients because of a potential for hypoxia and cardiopulmonary events.
authors.affiliation: Rothman Institute of Orthopedics, Thomas Jefferson University Hospital, 925 Chestnut Street, Philadelphia, PA 19107, USA. research@rothmaninstitute.com
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Adam G
authors.initials: AG
authors.lastname: Miller
authors.forename: Kishor
authors.initials: K
authors.lastname: Gandhi
mesh_terms: D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D006801:Humans; D009407:Nerve Block; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors