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Archive Opioids 2020

Multimodal Anesthesia Is a Must

Attacking pain's many pathways is the key to reducing opioid use.

Daniel Cook

Daniel Cook, Editor-in-Chief


Pamela Bevelhymer, RN, BSN, CNOR
DOUBLING UP Combining nerve blocks and local infusions of anesthetics with non-opioid therapies effectively manages post-op pain, even for the most complex procedures.

Those who accuse surgery of fanning the flames of the opioid epidemic point to misguided efforts to mask virtually all post-op pain and discomfort by writing prescriptions for too many heavy-duty opioids. Thankfully, surgical professionals are shifting from this single-minded focus to a multimodal approach to pain management that keeps patients as comfortable as possible during their recoveries, all the while shielding them from dependence and addiction.

“There was a heavy push to use opioids as the only means of providing pain control,” says Stavros Memtsoudis, MD, PhD, MBA, of the department of anesthesiology, critical care and pain management at the Hospital for Special Surgery in New York City. “Once opioids were identified as a problem, we had to offer a solution.”

Attacking surgical pain with a combination of local anesthetics and non-opioid medications is that solution, and has taken on greater importance in light of the opioid epidemic. Population-based studies involving hundreds of thousands of patients have backed the clinical benefits of multimodal pain management and shown how it impacts opioid consumption in the real world.

“We assumed it made a difference before we had the data — it made logical sense that using a combination of methods to manage post-op pain would reduce the need for opioids,” says Dr. Memtsoudis. “We’ve been able to put data behind those assumptions, and show on a big level that it’s true.”

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