Multimodal analgesia is defined by the American Society of Anesthesiologists (ASA) Task Force on Acute Pain Management in their 2012 Pratice Guideline update: “Multimodal techniques for pain management include the administration of two or more drugs that act by different mechanisms for providing analgesia. These drugs may be administered via the same route or by different routes.” Anesthesiology 2012; 116:248 –73
Perioperative non-opioid analgesics and adjuvants (parenteral and intravenous)
Acetaminophen
325 – 1000 mg po/pr q4-6 hrs (4 gm max/24 hrs)
1000 mg IV q6 hrs (4gm max/24 hrs)
Ketorolac
15-30 mg IV q 6 hrs
Celecoxib
400 mg po x 1 preop, or 200 mg po BID
Gabapentin
300-600 mg po preop, 300 mg po TID postop
Pregabalin
75-150 mg po preop, 75mg po BID postop
Ketamine
0.3-0.5 mg/kg IV loading dose, 0.1-0.5 mg/kg/hr IV infusion intraop
Lidocaine
1.5-2 mg/kg IV loading dose, 1.5-3 mg/kg/hr IV infusion intraop
Dexmedetomidine
0.5-1 mcg/kg IV loading dose, 0.2-0.7 mcg/kg/hr IV infusion intraop
Clonidine
150-200 mcg po preop