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Abstract
In the context of the current U.S. opioid crisis, there is renewed interest and heightened relevance in the practice of multimodal analgesia for postoperative surgical patients. The goal of this review article is to present an accounting of the available opioid and non-opioid pharmacologic agents, regional analgesia techniques, and complementary modalities that may be considered for optimal pain relief in the perioperative setting. In adhering to the practice of multimodal pain therapy, clinicians improve the quality of pain control and reduce reliance on opioid use. There is strong evidence to support the benefits of multimodal analgesia.
Highlights
Multimodal Pain Management This review article addresses the comprehensive approach to acute pain management in the perioperative setting
The goal of this review article is to present an accounting of the available opioid and non-opioid pharmacologic agents, regional analgesia techniques, and complementary modalities that may be considered for optimal pain relief in the perioperative setting
It is important to note that while opioid-induced hyperalgesia (OIH) is commonly discussed in the context of patients with chronic pain, OIH has been observed to develop acutely, namely during the intraoperative course when short-acting opioids such as remifentanil are infused over several hours [23]
Summary
Multimodal Pain Management This review article addresses the comprehensive approach to acute pain management in the perioperative setting. The discussion highlights multi-modal treatment strategies relevant to managing postoperative pain in patients undergoing common outpatient and inpatient surgeries. Traditional opioid therapy is reviewed, and many adjuvant analgesic agents are discussed individually. Procedural interventions such as neuraxial modalities and peripheral nerve blocks are addressed as important considerations for comprehensive perioperative pain management. Acute postoperative pain management is considered in the context of the patient with a history of chronic pain
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