MULTIMODAL PAIN MANAGEMENT
In the absence of reliable evidence, it is the opinion of the workgroup that multimodal pain management strategies or non-opioid individual modalities can provide added benefit for postoperative pain management following shoulder arthroplasty

Rationale

Mclaughlin et al performed a prospective study comparing standard opioid based versus multimodal pain management in patients who received elective or revision shoulder arthroplasty (anatomic or reverse). Opioid use in the multimodal cohort was lower on all days evaluated and there was a shorter length of stay with the multimodal group (1.44 vs 1.91days). There was no difference in 30- or 90-day ED visits.  

 

Strength of Evidence (quality of evidence): No reliable evidence

 

Benefits & Harms:
Reduction in opioid use reduces risks of side effects of medications as well potential risk of opioid diversion.Future Research: 
Future high-quality studies may focus on multimodal pain management after elective shoulder arthroplasty.


Additional References:

Mclaughlin, D.C., Cheah, J.W., Aleshi, P., Zhang, A.L., Ma, C.B., Feeley, B.T., Multimodal analgesia decreases opioid consumption after shoulder arthroplasty: a prospective cohort study. J Shoulder Elbow Surg. 2018;27(4):686-691.

 


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