Anesthesiology in Multimodal Pain Management for Orthopedic Patients

• DOI: 10.70789/jmse.v2i2.11
• Publication Date: 2025-01-18T14:14:32Z
• Authors: Victor Goya Machado; Aryane Cristina d...; Bia Priscila Silv...; João Francisco Me...; Matheus Teodoro H...; Luana De Queiroz ...; Eduardo Tiveron; Isabela Magosso d...; Henrique Bosso; Lucas Saraiva Gon...; Shalline Hermes S...; Mateus Fonseca Fr...; Celso Henrique De...

INTRODUCTION Multimodal pain management has emerged as a critical approach in orthopedic surgery, offering comprehensive pain control by integrating pharmacological and non-pharmacological methods. This strategy addresses the limitations of single-agent approaches and targets multiple pain pathways to optimize perioperative care. Regional anesthesia techniques, including nerve blocks and continuous catheters, have become central to multimodal protocols, enhancing pain relief while minimizing systemic side effects and opioid consumption. OBJETIVE To evaluate the role and effectiveness of multimodal pain management strategies in orthopedic surgery, focusing on their impact on pain control, patient outcomes, and opioid-sparing benefits. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Multimodal analgesia” OR “Orthopedic pain management” OR “Regional nerve blocks” OR “Non-opioid analgesics” OR “Anesthesiology advancements” in the last 5 years. RESULTS AND DISCUSSION The results demonstrate that multimodal strategies significantly reduce postoperative pain intensity, opioid dependency, and hospital length of stay, while improving patient satisfaction and early mobilization. Non-opioid medications such as acetaminophen and NSAIDs, when combined with regional anesthesia, show synergistic effects in managing pain effectively. However, challenges such as disparities in access, variability in implementation, and resource limitations remain barriers to widespread adoption. The analysis also highlights the cost-effectiveness of these approaches, which contribute to better patient outcomes and reduced healthcare expenditures. CONCLUSION In conclusion, multimodal pain management is a cornerstone of modern orthopedic anesthesiology, providing a safe, effective, and patient-centered approach to perioperative care. By reducing opioid reliance and improving recovery outcomes, these strategies address critical public health challenges and set a new standard for pain management in orthopedic surgery. Continued research and innovation are essential to further refine these protocols and expand their applicability to diverse patient populations.