Multimodal analgesia for acute pain
Multimodal analgesia combines analgesic agents and techniques with different mechanisms of action. Many nonpharmacological techniques, nonopioid analgesics, adjuvants and regional analgesic techniques are used as components of multimodal analgesia1.
Multimodal analgesia aims to improve pain relief due to additive or synergistic effects of different drugs or techniques while reducing individual drug dosages. For example, pain relief is improved if paracetamol, a nonsteroidal anti-inflammatory drug (NSAID) or a gabapentinoid is added to an opioid regimen.
Most commonly, multimodal analgesia is used to decrease the opioid dosage required (‘opioid-sparing’) and the likelihood of opioid-related adverse effects. However, introducing an additional analgesic may compound adverse effects. For example, when combined with opioids, gabapentinoids are associated with a higher incidence of sedation, dizziness, visual disturbances and opioid-induced ventilatory impairment.