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Review
. 2018 Jan-Mar;9(1):40-45.
doi: 10.1016/j.jcot.2017.09.014. Epub 2017 Sep 28.

Perioperative pain management following total joint arthroplasty: A review and update to an institutional pain protocol

Kimberly L Stevenson  1 , Alexander L Neuwirth  1 , Neil Sheth  2
Affiliations
Review

Perioperative pain management following total joint arthroplasty: A review and update to an institutional pain protocol

Kimberly L Stevenson et al. J Clin Orthop Trauma. 2018 Jan-Mar.

Abstract

As the rate of total joint arthroplasty increases with the aging population of the United States, new focus on decreasing opioid use through the development of multimodal pain regimens (MPRs) is becoming an important area of research. MPRs use different agents and modes of delivery in order to synergistically address pain at many levels of the pain pathway. MPRs include a combination of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, opioids (short- and long-acting), spinal/epidural analgesia, regional nerve blocks, and local anesthetics. This review summarizes the available literature on major components of MPRs shown to be effective in the total joint arthroplasty population. Finally, the authors' preferred method for pain control in the TJA population is reviewed.

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Figures

Fig. 1
Fig. 1
Instructions and cartoon included in Pre-operative Patient Information Booklet indicating proper timing and location of Lidoderm patch application.
See this image and copyright information in PMC

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