Analgesia in Total Knee Arthroplasty
Spencer Summers, Neil Mohile, Colin McNamara, Brian M. Osman, Ralf E. Gebhard, Victor H. Hernandez
Abstract
➢ Implementation of multimodal pain management regimens after total knee arthroplasty has increased patient satisfaction, decreased pain scores, and facilitated faster recovery. ➢ A variety of oral and intravenous analgesics, including nonsteroidal anti-inflammatory drugs, gabapentinoids, acetaminophen, and opioids, can be employed preoperatively and postoperatively. ➢ Neuraxial anesthesia, peripheral nerve blocks, and periarticular injections are effective pain modulators that should be implemented in concert with the anesthesia teams. ➢ There is no consensus on the optimal multimodal pain regimen, and substantial variability exists between institutions and providers. ➢ The goals of minimizing pain and improving functional recovery in the postoperative period must be considered in light of evidence-based practice as well as the risk profile of the proposed analgesic treatment.