An Update on Multimodal Pain Management After Total Joint Arthroplasty
Joseph Karam, Eric S. Schwenk, Javad Parvizi
Abstract
➤: Multimodal analgesia has become the standard of care for total joint arthroplasty as it provides superior analgesia with fewer side effects than opioid-only protocols. ➤: Systemic medications, including nonsteroidal anti-inflammatory drugs, acetaminophen, corticosteroids, and gabapentinoids, and local anesthetics via local infiltration analgesia and peripheral nerve blocks, are the foundation of multimodal analgesia in total joint arthroplasty. ➤: Ideally, multimodal analgesia should begin preoperatively and continue throughout the perioperative period and beyond discharge. ➤: There is insufficient evidence to support the routine use of intravenous acetaminophen or liposomal bupivacaine as part of multimodal analgesia protocols.