title: Multimodal therapy in perioperative analgesia.
abstract: This article reviews the current evidence for multimodal analgesic options for common surgical procedures. As perioperative physicians, we have come a long way from using only opioids for postoperative pain to combinations of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), selective Cyclo-oxygenase (COX-2) inhibitors, local anesthetics, N-methyl-d-aspartate (NMDA) receptor antagonists, and regional anesthetics. As discussed in this article, many of these agents have decreased narcotic requirements, improved patient satisfaction, and decreased postanesthesia care unit (PACU) times, as well as morbidity in the perioperative period.
authors.affiliation: Department of Anesthesiology, Montefiore Medical Center, Bronx, New York, NY, USA; Department of Family and Social Medicine, Montefiore Medical Center, Bronx, New York, NY, USA; Acute Pain, Regional, Chronic Pain, Montefiore Medical Center, Bronx, New York, NY, USA; Albert Einstein College of Medicine, Yeshiva University, Montefiore Medical Center, Bronx, New York, NY, USA. Electronic address: karina.gritsenko@gmail.com.
authors.forename: Karina
authors.initials: K
authors.lastname: Gritsenko
authors.affiliation: Anesthesiology, Icahn School of Medicine of Mount Sinai, New York, NY, USA; Pain Medicine Fellowship Program, Icahn School of Medicine of Mount Sinai, New York, NY, USA.
authors.forename: Yury
authors.initials: Y
authors.lastname: Khelemsky
authors.affiliation: Department of Anesthesiology, LSU School of Medicine, New Orleans, LA, USA; Interventional Pain Services, LSU School of Medicine, New Orleans, LA, USA; Department of Pharmacology, LSU School of Medicine, New Orleans, LA, USA; Department of Anesthesiology, Tulane School of Medicine, New Orleans, LA, USA; Department of Pharmacology, Tulane School of Medicine, New Orleans, LA, USA.
authors.forename: Alan David
authors.initials: AD
authors.lastname: Kaye
authors.affiliation: Anesthesiology Department, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Nalini
authors.initials: N
authors.lastname: Vadivelu
authors.affiliation: Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, Brigham and Women's Hospital, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D019990:Perioperative Care / Q000379:methods
chemical_list: D000700:Analgesics
keywords: acute pain; adjuvant medication; balanced anesthesia; chronic postoperative pain; multimodal perioperative analgesia; persistent postoperative pain; postoperative pain; regional anesthesia