Multimodal pain management for total hip arthroplasty

Multimodal pain management uses a variety of pharmacological agents administered at different perioperative times to target both peripheral and central nerve transduction and the various biochemical pathways, enzymes and receptors that signal painful stimuli and inflammation. This article reviews the role of patient-controlled analgesia, peripheral nerve blocks, local periarticular injections and extended-release epidural morphine injections that can be used in a multidisciplinary approach to analgesia. By decreasing narcotic consumption and improving pain control, multimodal pain management can reduce the numerous adverse effects associated with increased opioid use and improve mobility with physical therapy, both of which can have a direct effect on decreasing length of stay and reducing serious perioperative complications.