Date of Award

11-2024

Document Type

Dissertation

Degree Name

Doctor of Medical Science (DMSc)

First Advisor

Jason Brumitt

Second Advisor

Curt Stilp, EdD, PA-C

Third Advisor

Shane Merrill DNAP, APRN

Abstract

Background: The opioid epidemic ranks among the most significant public health crises of our time, with prolonged opioid use often resulting from overprescription following surgeries such as total knee arthroplasty.

Methods: PubMed and Medline (EBSCO) were searched from inception until July 2024 for studies comparing multimodal pain management interventions aimed at reducing opioid use after total knee arthroplasty (TKA) to a control group. Twenty-eight articles were identified that met the inclusion criteria.

Results: Opioid-sparing multimodal pain management approaches, including acetaminophen, non-steroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, gabapentinoids, peripheral nerve blocks, cryoneurolysis and local infiltration analgesia, can effectively manage pain after a TKA.

Conclusion: Multimodal analgesic pain management is an effective, opioid-sparing strategy to manage perioperative pain following a TKA. Future research trials are needed to provide more conclusive evidence-based information, as the comparison of some similar trials had conflicting evidence.

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