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Practice Consideration
Regional + Multimodal Pain Management (Practice Consideration)
Last AANA revision: 2023
Our paraphrased summary. The text below is our own condensed phrasing for board review, derived from the AANA Practice Manual document of the same name. The AANA document is the authoritative source — read it on aana.com for legally-binding language.
Multimodal opioid-sparing analgesia improves outcomes, reduces opioid-related complications, and supports ERAS protocols. Regional anesthesia (peripheral nerve blocks, neuraxial) combined with non-opioid adjuncts (acetaminophen, NSAID, gabapentinoid, ketamine, dexmedetomidine, lidocaine infusion) is preferred over opioid monotherapy whenever possible.
Key points
- 1.Multimodal triad: regional + scheduled APAP + NSAID (or alternative if contraindicated)
- 2.Adjuncts by case: gabapentinoid for neuropathic; ketamine 0.1–0.3 mg/kg/hr for opioid-tolerant; lido infusion 1–3 mg/kg/hr for laparoscopic
- 3.PNB techniques: TAP, fascia iliaca, adductor canal, IPACK, ESP, paravertebral
- 4.ASRA Anticoagulation guidelines 2018 — must be followed for all neuraxial / deep blocks
- 5.Document block pre-op, post-PACU motor + sensory check, follow-up day for catheters
This is an exam-prep summary, not a substitute for the full AANA document. Read the source at aana.com for authoritative wording. Education only.