Multi-modal pain management for total knee replacement

Multi-modal pain management is probably the most important method adopted in past 10 years to improve post-operative recovery of total knee replacement patients. The goal is to provide sufficient pain relief to perform rehabilitation, while minimizing side effects from the treatment. A reduction in narcotic use will lessen side effects such as sedation, nausea, vomiting, ileus, urinary retention, and respiratory depression. Medications, nerve blocks, and peri-articular injections are directed toward the brain, dorsal root ganglia, and peripheral nerves. Improved post-operative recovery can be achieved lessening hospital stays and facilitate outpatient surgery. The author’s current method of multi-modal pain management is described.