Multimodal pain management reduces opioid use, complications after total joints

Editor's Note

Using a multimodal approach to pain management was associated with decreased opioid use, opioid prescriptions, and opioid complications in total joint replacement patients in this study.

Of 512,393 hip replacement and 1,028,069 knee replacement patients analyzed, multimodal pain management techniques were used in 85.6% during surgery, on the day of surgery, or during recovery.

Compared with total hip patients receiving opioids alone, those receiving more than two methods of pain relief in addition to opioids had:

• 19% fewer respiratory complications
• 26% fewer gastrointestinal complications
• an 18.5% decrease in opioid prescriptions
• a 12% decrease in length of stay.

Total knee patients who received more than two methods of pain relief in addition to opioids had similar results.

Though optimal multimodal regimens are still not known, the findings encourage the combined use of multiple modalities in perioperative analgesic protocols, the authors conclude.

Multimodal analgesia is increasingly considered routine practice in joint arthroplasties, but supportive large-scale data are scarce. The authors aimed to determine how the number and type of analgesic modes is associated with reduced opioid prescription, complications, and resource utilization.