Practice Consideration

Regional + Multimodal Pain Management (Practice Consideration)

Last AANA revision: 2023

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.