ReviewHSS journal : the musculoskeletal journal of Hospital for Special Surgery2019
Regional and Multimodal Analgesia to Reduce Opioid Use After Total Joint Arthroplasty: A Narrative Review.
Review in HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 4 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- IPACK (Interspace between the Popliteal Artery and the Capsule of the Posterior Knee) Block Combined with SACB (Single Adductor Canal Block) Versus SACB for Analgesia after Total Knee Arthroplasty.Orthopaedic surgery · 2022Pooled it
- Pooled it
- Pooled it
- Intrathecal versus local infiltration analgesia for pain control in total joint arthroplasty.Journal of orthopaedic surgery and research · 2020Pooled it
- No superior method for analgesia after total knee arthroplasty: randomised controlled comparison of adductor canal block combined with iPACK block versus posterior capsule block.Archives of orthopaedic and trauma surgery · 2025Trial
- [Fast-Track-Arthroplasty].Orthopadie (Heidelberg, Germany) · 2024Trial
- Comparison between Ultrasound-Guided Pericapsular Nerve Group Block and Local Infiltration Analgesia for Postoperative Analgesia after Total Hip Arthroplasty: A Prospective Randomized Controlled Trial.Orthopaedic surgery · 2023Trial
- A randomized controlled trial of iliopsoas plane block vs. femoral nerve block for hip arthroplasty.BMC anesthesiology · 2023Trial
- An opioid-sparing protocol with intravenous parecoxib can effectively reduce morphine consumption after simultaneous bilateral total knee arthroplasty.Scientific reports · 2021Trial
- Efficacy of popliteal plexus block for opioid sparing and pain management after lower extremity surgery: a meta-analysis.The Korean journal of pain · 2026Article
- Regional Blocks in the Era of the Opioid Crisis: Evaluating Their Opioid-Sparing Effect.Cureus · 2026Review
- Comparison of multimodal analgesia including intermediate cervical plexus block versus local infiltration analgesia after carotid endarterectomy: a randomized observer-blinded trial.Anesthesia and pain medicine · 2026Article
- Factors driving higher opioid use after total hip arthroplasty: Insights from a large-scale, tertiary centre analysis.SICOT-J · 2026Article
- Personalized Multimodal and Opioid-Sparing Analgesia for Postoperative Pain Management: Enhancing Recovery and Addressing the Post-Discharge Gap.Journal of pain research · 2026Review
- From Bench to Bedside: New Frontiers in Understanding and Treating Postoperative Delirium.Journal of clinical medicine · 2025Review
- Association of peripheral nerve blocks with increased postoperative pain and opioid use in orthopaedic surgery: a single-centre retrospective cohort study.British journal of anaesthesia · 2025Article
- Ultrasound-guided suprainguinal fascia iliaca block versus lumbar erector spinae block for oncologic thigh surgery.Pain reports · 2025Article
- Article
- Article
- Comparative Review of Postoperative Analgesic Use After Total Hip Replacement: Opioids Versus Non-opioids.Cureus · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElective total joint arthroplasty may be a gateway to long-term opioid use. QUESTIONS/PURPOSE: We sought to review the literature on multimodal and regional analgesia as a strategy to minimize perioperative opioid use and control pain in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA).
methodsWe conducted a narrative review to assess the state of the evidence informing opioid-sparing analgesics for THA and TKA. A PubMed search was conducted for English-language articles published before April 2018. We preferentially included well-designed randomized controlled trials, systematic reviews, and meta-analyses. Where the highest levels of evidence were not yet apparent, we evaluated retrospective and/or observational studies.
resultsMultimodal analgesia emphasizing nonsteroidal anti-inflammatory agents and acetaminophen is associated with decreases in perioperative opioid use for THA and TKA. Regional analgesia, including peripheral nerve blocks and local infiltration analgesia, is also associated with decreased perioperative opioid use for THA and TKA. Emerging topics in post-arthroplasty analgesia include (1) the value of nonsteroidal anti-inflammatory drugs, (2) the use of peripheral nerve catheters and extended-release local anesthetics to prolong the duration of opioid-free analgesia, and (3) novel peripheral nerve blocks, exemplified by the IPACK (interspace between the popliteal artery and posterior capsule of the knee) block for TKA.
conclusionsThe use of multimodal analgesia with regional techniques may decrease perioperative opioid use for patients undergoing THA and TKA. These techniques should be part of a comprehensive perioperative plan to promote adequate analgesia while minimizing overall opioid exposure.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.