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- W1985324768 abstract "Multimodal approaches to pain management have arisen with the goal of improving postoperative pain and reducing opioid analgesic use. We performed a comprehensive literature review to determine grades of recommendation for commonly used agents in multimodal pain management and provide a best practice guideline. To evaluate common drugs used in multimodal treatment of pain, a search was performed on English language publications on Medline (PubMed; National Library of Medicine, Bethesda, MD, USA). Manuscripts were rated as Level I–V according to the North American Spine Society’s (NASS) standardized levels of evidence tables. Grades of recommendation were assigned for each drug based on the NASS Clinical Guidelines for Multidisciplinary Spine Care. There is good (Grade A) evidence gabapentinoids, acetaminophen, neuraxial blockade and extended-release local anesthetics reduce postoperative pain and narcotic requirements. There is fair (Grade B) evidence that preemptive analgesia and nonsteroidal anti-inflammatory drugs (NSAID) result in reduced postoperative pain. There is insufficient and/or conflicting (Grade I) evidence that muscle relaxants and ketamine provide a significant reduction in postoperative pain or narcotic usage. There is fair (Grade B) evidence that short-term use of NSAID result in no long-term reduction in bone healing or fusion rates. Comprehensive assessment of the effectiveness of perioperative pain control can be accomplished through the use of validated measures. Multimodal pain management protocols have consistently been demonstrated to allow for improved pain control with less reliance on opioids. There is good quality evidence that supports many of the common agents utilized in multimodal therapy, however, there is a lack of evidence regarding optimal postoperative protocols or pathways." @default.
- W1985324768 created "2016-06-24" @default.
- W1985324768 creator A5010883015 @default.
- W1985324768 creator A5029505495 @default.
- W1985324768 date "2015-06-01" @default.
- W1985324768 modified "2023-10-05" @default.
- W1985324768 title "Best evidence in multimodal pain management in spine surgery and means of assessing postoperative pain and functional outcomes" @default.
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- W1985324768 doi "https://doi.org/10.1016/j.jocn.2015.01.003" @default.
- W1985324768 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/25766366" @default.
- W1985324768 hasPublicationYear "2015" @default.
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