Key result
Multimodal analgesia protocols cut opioid use and adverse effects while improving recovery versus IV opioids.
Why the study?
Do multimodal analgesia protocols reduce opioid consumption and improve recovery in postoperative patients compared to primarily IV opioid patient-controlled analgesia?
Do multimodal analgesia protocols reduce opioid consumption and improve recovery in postoperative patients compared to primarily IV opioid patient-controlled analgesia?
Multimodal analgesia protocols optimize postoperative pain management by reducing opioid consumption and associated side effects, thereby improving patient recovery and resource utilization.
May support multimodal protocols postoperatively; extends Level 5 evidence but leaves open need for RCTs.
Multimodal analgesia (MMA) involves the use of additive or synergistic combinations of analgesics to achieve clinically required analgesia while minimizing significant side effects associated with higher dose of a single equianalgesic medication such as an opioid analgesic. MMA generally involves optimizing non-opioid pharmacologic and non-pharmacologic interventions and reserving opioid use to treat breakthrough pain. Patients receiving medications via MMA protocols are likely to have lower opioid consumption compared to those managed using primarily IV opioid patient-controlled analgesia. MMA pain management strategies have become important components of enhanced recovery after surgery (ERAS) protocols in an effort to optimize care by standardizing analgesic medications in the perioperative setting while minimizing adverse effects and improving quality and patient outcomes. Successful implementation of a MMA requires the input and cooperation of all of the stakeholders including the caregivers as well as the patients. Health system benefits can also be realized from the implementation of an effective MMA, as fewer opioid related side effects can improve patient recovery and lead to faster discharge and improved utilization of resources.
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Bhatia et al. (2019) conducted a review in Postoperative pain. Multimodal analgesia (MMA) vs. IV opioid patient-controlled analgesia was evaluated. Multimodal analgesia protocols optimize non-opioid interventions to reduce opioid consumption, minimize adverse effects, and improve patient recovery compared to primarily IV opioid analgesia.
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