Multimodal analgesia best at managing pain, complications after arthroplasty — 5 findings

Written by Angie Stewart | July 11, 2018 | Print  |

An analysis of data from more than 1.5 million patients confirmed multimodal analgesia for joint arthroplasty is most effective at controlling pain and reducing complications, Anesthesiology News reports. 

To determine if the number and type of analgesic modes are associated with decreased complications and opioid prescriptions, researchers from New York City-based Hospital for Special Surgery analyzed data gathered from 546 U.S. hospitals between 2006 and 2016. They studied 512,393 hip arthroplasties and 1,028,069 knee arthroplasties.

Here are five findings:

1. Of patients included in the study, 85.6 percent received multimodal analgesia. In multivariable models, adding analgesic modes had positive associations.

2. When compared with patients who only received opioids, total hip arthroplasty patients given more than two modes of analgesia had 19 percent fewer respiratory complications, 26 percent fewer gastrointestinal complications, an 18.5 percent decrease in opioid prescriptions and a 12.1 percent decrease in length of stay.

Patients who underwent total knee arthroplasty had similar results.

3. Researchers found nonsteroidal anti-inflammatory drugs and COX-2 inhibitors were the most effective modalities, with the biggest reduction in opioid prescriptions and complication risk.

4. Using a peripheral nerve block effectively reduced complications and opioid prescriptions, the study showed.

5. Researchers noted the study doesn't indicate which combinations of analgesic approaches are most effective.

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