The Orthopedic clinics of North America
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Multimodal analgesia incorporates the use of analgesic adjuncts with different mechanisms of action to enhance postoperative pain management. Acetaminophen, anti-inflammatories, and gabapentinoids provide effective analgesia while reducing opioid requirements and opioid-related side effects. Intrathecal morphine and periarticular local anesthetic infiltration further enhance dynamic analgesia and improve postoperative mobilization. Epidural analgesia, peripheral nerve blocks, tramadol, ketamine, and/or clonidine can be added for improved benefit in opioid-tolerant individuals.