Table.

Analgesic Options for Multimodal Analgesia

Class of Analgesic Agent/ Technique	Advantages	Disadvantages	References
Acetaminophen	↓ Pain, opioid-sparing effect, nonopioid analgesia	Liver toxicity	33-40
α-2 agonists (eg, clonidine and dexmedetomidine)	↓ Pain, opioid-sparing effect, nonopioid analgesia	Hypotension, bradycardia, sedation	41-45
Gabapentinoids (eg, gabapentin and pregabalin)	↓ Pain, opioid-sparing effect, nonopioid analgesia	Dizziness, sedation, peripheral edema, renally excreted, potential respiratory depression	46-58
IV lidocaine	↓ Pain, facilitates return of gastrointestinal function	Optimal dosage regimen uncertain	59-62
N-methyl-D-aspartate antagonists (eg, ketamine, magnesium, and dextromethorphan)	↓ Pain, opioid-sparing effect, nonopioid analgesia	Optimal dosage regimen uncertain	63-70
NSAIDs (eg, ibuprofen, ketorolac, meloxicam, and celecoxib)	↓ Pain, opioid-sparing effect, nonopioid analgesia	Platelet dysfunction, gastrointestinal irritation, renal dysfunction	71-76
Regional anesthesia/analgesia	↓ Pain, opioid-sparing effect, nonopioid analgesia	Failure of technique, local anesthetics: hypotension, motor block. Opioids: pruritus, potential respiratory depression	77-86
Steroids (eg, methylprednisolone and dexamethasone)	↓ Pain, ↓ length of recovery room stay	↑ Serum glucose levels (controversial)	87-91
Wound infiltration (local anesthetics)	Fast and simple technique, minimal risk	Duration of analgesia limited to duration of action of local	92-95

The Table was reused with the permission of the Perioperative Quality Initiative (POQI). For permission requests, contact info@poqi.org.

Abbreviations: IV, intravenous; NSAID, nonsteroidal anti-inflammatory drug.