Perioperative multimodal analgesia: a review of efficacy and safety of the treatment options

Pain in the postoperative period is a common patient experience that can subsequently lead to other postoperative complications if not managed appropriately. While opioids are a common pharmacologic tool for managing pain, there are risks associated with liberal opioid use. Multimodal analgesic stra...

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Published inANESTHESIOLOGY AND PERIOPERATIVE SCIENCE Vol. 2; no. 1; pp. 1 - 16
Main Authors Kianian, Sara, Bansal, Jahnvi, Lee, Christopher, Zhang, Kalissa, Bergese, Sergio D.
Format Journal Article
LanguageEnglish
Published Singapore Springer Nature Singapore 25.01.2024
Springer
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Abstract Pain in the postoperative period is a common patient experience that can subsequently lead to other postoperative complications if not managed appropriately. While opioids are a common pharmacologic tool for managing pain, there are risks associated with liberal opioid use. Multimodal analgesic strategies, however, can adequately manage postoperative pain and minimize the risks associated with opioids. In this review, common pharmacological treatments for multimodal analgesia will be reviewed for efficacy, risks, and benefits, including gabapentinoids, opioids, alpha-2 agonists, ketamine, Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. While this may not be a comprehensive list of medication options, it represents some of the most commonly used pharmacologic techniques for managing pain in the perioperative period. In addition, newer regional anesthetic techniques will be discussed to review their efficacy, risks, and benefits as well. The goal of this review is to summarize the various options for a multimodal analgesic protocol that we encourage providers to utilize when managing postoperative pain to facilitate conservative opioid usage and improve patient outcomes overall. Graphical Abstract
AbstractList Pain in the postoperative period is a common patient experience that can subsequently lead to other postoperative complications if not managed appropriately. While opioids are a common pharmacologic tool for managing pain, there are risks associated with liberal opioid use. Multimodal analgesic strategies, however, can adequately manage postoperative pain and minimize the risks associated with opioids. In this review, common pharmacological treatments for multimodal analgesia will be reviewed for efficacy, risks, and benefits, including gabapentinoids, opioids, alpha-2 agonists, ketamine, Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. While this may not be a comprehensive list of medication options, it represents some of the most commonly used pharmacologic techniques for managing pain in the perioperative period. In addition, newer regional anesthetic techniques will be discussed to review their efficacy, risks, and benefits as well. The goal of this review is to summarize the various options for a multimodal analgesic protocol that we encourage providers to utilize when managing postoperative pain to facilitate conservative opioid usage and improve patient outcomes overall. Graphical Abstract
Abstract Pain in the postoperative period is a common patient experience that can subsequently lead to other postoperative complications if not managed appropriately. While opioids are a common pharmacologic tool for managing pain, there are risks associated with liberal opioid use. Multimodal analgesic strategies, however, can adequately manage postoperative pain and minimize the risks associated with opioids. In this review, common pharmacological treatments for multimodal analgesia will be reviewed for efficacy, risks, and benefits, including gabapentinoids, opioids, alpha-2 agonists, ketamine, Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. While this may not be a comprehensive list of medication options, it represents some of the most commonly used pharmacologic techniques for managing pain in the perioperative period. In addition, newer regional anesthetic techniques will be discussed to review their efficacy, risks, and benefits as well. The goal of this review is to summarize the various options for a multimodal analgesic protocol that we encourage providers to utilize when managing postoperative pain to facilitate conservative opioid usage and improve patient outcomes overall. Graphical Abstract
ArticleNumber 9
Author Lee, Christopher
Bansal, Jahnvi
Kianian, Sara
Zhang, Kalissa
Bergese, Sergio D.
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  givenname: Sara
  orcidid: 0000-0003-4060-133X
  surname: Kianian
  fullname: Kianian, Sara
  email: skianian@stanford.edu
  organization: Renaissance School of Medicine, Stony Brook University, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center
– sequence: 2
  givenname: Jahnvi
  surname: Bansal
  fullname: Bansal, Jahnvi
  organization: Renaissance School of Medicine, Stony Brook University, Department of Anesthesiology, Westchester Medical Center
– sequence: 3
  givenname: Christopher
  surname: Lee
  fullname: Lee, Christopher
  organization: Department of Anesthesiology, Stony Brook University Health Science Center
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  givenname: Kalissa
  surname: Zhang
  fullname: Zhang, Kalissa
  organization: Department of Anesthesiology, Stony Brook University Health Science Center
– sequence: 5
  givenname: Sergio D.
  surname: Bergese
  fullname: Bergese, Sergio D.
  organization: Department of Anesthesiology, Stony Brook University Health Science Center, Department of Neurosurgery, Stony Brook University Health Science Center
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Snippet Pain in the postoperative period is a common patient experience that can subsequently lead to other postoperative complications if not managed appropriately....
Abstract Pain in the postoperative period is a common patient experience that can subsequently lead to other postoperative complications if not managed...
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SubjectTerms Anesthesiology
Critical Care Medicine
Intensive
Medicine
Medicine & Public Health
Multimodal analgesia
Neurosciences
Pharmacology/Toxicology
Postoperative complications
Postoperative pain
Review Article
Surgery
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Title Perioperative multimodal analgesia: a review of efficacy and safety of the treatment options
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