Multimodal therapy in perioperative analgesia

Karina Gritsenko, Yury Khelemsky, Alan David Kaye, Nalini Vadivelu, Richard D. Urman

Research output: Contribution to journalReview articlepeer-review

103 Scopus citations


This article reviews the current evidence for multimodal analgesic options for common surgical procedures. As perioperative physicians, we have come a long way from using only opioids for postoperative pain to combinations of acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), selective Cyclo-oxygenase (COX-2) inhibitors, local anesthetics, N-methyl-d-aspartate (NMDA) receptor antagonists, and regional anesthetics. As discussed in this article, many of these agents have decreased narcotic requirements, improved patient satisfaction, and decreased postanesthesia care unit (PACU) times, as well as morbidity in the perioperative period.

Original languageEnglish (US)
Pages (from-to)59-79
Number of pages21
JournalBest Practice and Research: Clinical Anaesthesiology
Issue number1
StatePublished - Mar 2014


  • acute pain
  • adjuvant medication
  • balanced anesthesia
  • chronic postoperative pain
  • multimodal perioperative analgesia
  • persistent postoperative pain
  • postoperative pain
  • regional anesthesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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