The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques: A Review
Abstract
Importance: Amid the current opioid epidemic in the United States, the enhanced recovery after surgery pathway (ERAS) has emerged as one of the best strategies to improve the value and quality of surgical care and has been increasingly adopted for a broad range of complex surgical procedures. The goal of this article was to outline important components of opioid-sparing analgesic regimens. Observations: Regional analgesia, acetaminophen, nonsteroidal anti-inflammatory agents, gabapentinoids, tramadol, lidocaine, and/or the N-methyl-d-aspartate class of glutamate receptor antagonists have been shown to be effective adjuncts to narcotic analgesia. Nonsteroidal anti-inflammatory agents are not associated with an increase in postoperative bleeding. A meta-analysis of 27 randomized clinical trials found no difference in postoperative bleeding between the groups taking ketorolac tromethamine (33 of 1304 patients [2.5%]) and the control groups (21 of 1010 [2.1%]) (odds ratio [OR], 1.1; 95% CI, 0.61-2.06; P = .72). After adoption of the multimodal analgesia approach for a colorectal ERAS pathway, most patients used less opioids while in the hospital and many did not need opioids after hospital discharge, although approximately 50% of patients received some opioid during their stay. Conclusions and Relevance: Multimodal analgesia is readily available and the evidence is strong to support its efficacy. Surgeons should use this effective approach for patients both using and not using the ERAS pathway to reduce opioid consumption.
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Citations
Cites
1 retracted
Perioperative ketamine for acute postoperative pain
Bell, R. F., Dahl, J. B., Moore, R. A., & Kalso, E. A. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004603.pub2 · Cited by 426
RetractedHorlocker, T. T., Wedel, D. J., Rowlingson, J. C., Enneking, F. K., Kopp, S. L., Benzon, H. T., Brown, D. L., Heit, J. A., Mulroy, M. F., Rosenquist, R. W., et al. (2010) · Regional Anesthesia and Pain Medicine · doi:10.1097/aap.0b013e3181c15c70 · Cited by 1,501
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Efficacy of Postoperative Epidural Analgesia: A Meta-analysis
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Self-citationA Flood of Opioids, a Rising Tide of Deaths
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Trends in Opioid Analgesic–Prescribing Rates by Specialty, U.S., 2007–2012
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JCAHO Pain Management Standards Are Unveiled
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Cited by
Engelman, D. T., Ben Ali, W., Williams, J. B., Perrault, L. P., Reddy, V. S., Arora, R. C., Roselli, E. E., Khoynezhad, A., Gerdisch, M., Levy, J. H., et al. (2019) · JAMA Surgery · doi:10.1001/jamasurg.2019.1153 · Cited by 1,225
Nelson, G., Bakkum-Gamez, J., Kalogera, E., Glaser, G., Altman, A., Meyer, L. A., Taylor, J. S., Iniesta, M., Lasala, J., Mena, G., et al. (2019) · International Journal of Gynecological Cancer · doi:10.1136/ijgc-2019-000356 · Cited by 758
Paracetamol: A Review of Guideline Recommendations
Freo, U., Ruocco, C., Valerio, A., Scagnol, I., & Nisoli, E. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10153420 · Cited by 208
“Paracetamol has a role in the multimodal approach [71].”
BackgroundThybo, K. H., Hägi-Pedersen, D., Dahl, J. B., Wetterslev, J., Nersesjan, M., Jakobsen, J. C., Pedersen, N. A., Overgaard, S., Schrøder, H. M., Schmidt, H., et al. (2019) · JAMA · doi:10.1001/jama.2018.22039 · Cited by 142
VX-548 in the treatment of acute pain
Hang Kong, A. Y., Tan, H. S., & Habib, A. S. (2024) · Pain Management · doi:10.1080/17581869.2024.2421749 · Cited by 31
Metadata
- Authors
- Wick, E. C., Grant, M. C., & Wu, C. L.
- Venue
- JAMA Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 2017-07-01
- Volume
- 152
- Issue
- 7
- Pages
- 691
- ISSN
- 2168-6254 (ISSN-L)
- OpenAlex
- W2618114875
- Cited by
- 1,009
- References
- 32
- FWCI
- 70.24
- Type
- journal article
- Language
- en
- Open access
- closed
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- Wick, E. C., Grant, M. C., & Wu, C. L. (2017). Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques: A Review. JAMA Surgery. https://doi.org/10.1001/jamasurg.2017.0898
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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