Perioperative Pain Management in Total Knee Arthroplasty: A Narrative Review of Current Multimodal Analgesia Protocols

Abstract

Since there is no consensus on the optimal perioperative analgesic method, the present article provides a brief and practical synthesis on current multimodal pre–postsurgery analgesia protocols for primary TKA (excluding intraoperative anesthetic techniques) reported especially in recent meta-analyses and reviews. The focus is not only on the traditional aims (pain scores and opioid sparing), but also the functional recovery and patient-reported outcomes. Multimodal analgesia (pre-emptive analgesia, local infiltration analgesia, peripheral nerve blocks, and specific systemic drugs) is considered the optimal regimen for perioperative pain management of TKA.

Keywords

• perioperative pain management
• total knee arthroplasty
• analgesia
• opioid
• NSAID
• multimodal