Surgical & Healthcare Alliance for enhanced Recovery & Pain Management (SHARP) Six Part Mini-Lecture Series-CME Paid Option-Multimodal Analgesia

Video Transcription

Video Summary

Dr. Jennifer Ha reviews regional anesthesia as a key component of multimodal analgesia. Regional techniques and surgical field blocks can reduce postoperative pain, opioid needs, and possibly chronic post-surgical pain, but require early planning with anesthesia teams and attention to maximum local anesthetic dosing and rebound pain. Evidence from meta-analyses suggests regional anesthesia reduces prolonged opioid use and may lower postoperative neurocognitive dysfunction, though overall evidence quality is often low. The lecture surveys common blocks (TAP, rectus sheath, serratus/PECS, quadratus lumborum, wound catheters) and extensive options for total joint arthroplasty, where peripheral nerve blocks reduce complications and opioid use; targeted blocks can match local infiltration while using less anesthetic, and mixing techniques often adds little benefit. Liposomal bupivacaine has mixed results and high cost; clinicians must consider toxicity precautions. Procedure-specific examples include tonsillectomy, cardiac and thoracic surgery, and hand surgery with elevated risk of persistent pain.

Keywords

regional anesthesia

multimodal analgesia

peripheral nerve blocks

total joint arthroplasty analgesia

liposomal bupivacaine