Administering these
agents after surgery
has been shown to
decrease opioid con-
sumption. Current
clinical evidence fails
to show one drug is
more effective than
the other, but does
indicate using both in
combination provides
the greatest analgesic effect.
In March 2018, Dr. Memtsoudis published a study that compared the
outcomes of 1,028,069 total knee patients and 512,393 hip replace-
ment patients who underwent surgery at 546 facilities across the
country and received opioids only or multimodal therapies to manage
post-op pain. Using more than 2 methods of pain relief in hip and
knee replacement patients who didn't receive opioids reduced post-op
opioid prescriptions by up to 18.5% and resulted in fewer complica-
tions and shorter lengths of stay, according to the research.
Importantly, 85% of patients involved in the study received multi-
modal anesthesia. The study also showed NSAIDs and COX-2
inhibitors caused the greatest reduction in opioid prescriptions and
complication risks. Dr. Memtsoudis was encouraged by the results,
but he won't be satisfied until all patients — in his health system and
beyond — benefit from multifaceted attacks on pain.
"We'll get there," he says, "by identifying reasons providers are not
using multimodal anesthesia and, when they are using it, providing
rationale and evidence regarding the modalities and drugs involved.
"Pharmaceutical companies push the use of promising new drugs
J A N U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 2 3
• TRIED AND TRUE New pain medications are promising developments, but don't
ignore the importance and effectiveness of proven analgesics.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
