Evidence indicates that early analgesia reduces postoperative problems.Recent studies endorse the multimodal approach to both preemptive (preventative)and postoperative analgesia customized to patient needs based on meticulous preoperative assessment.A 72-year-old physically active woman was seen in the preoperative admission center in preparation for her total knee replacement surgery on Thursday.She has not had any opioid medications in her lifetime that she can remember.She has inflammatory bowel and gastric disease and was told she cannot take ibuprofen in any form.Select a multimodal analgesic treatment plan that would best serve the patient's perianesthesia experience.

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During preadmission testing/preparation,staff should identify candidates for PCA and teach its use,including the benefits of effective pain control,use of the pain scale,and the importance of reporting pain early.Evidence indicates that early analgesia reduces postoperative problems.Nonsteroidal anti-inflammatory drugs (NSAIDs)and opiates are the analgesics of choice.Generally,they are used in combination (multimodal therapy)in the PACU.Using NSAIDs in combination with opiates can reduce opioid requirements by 20% to 40%.Traditionally,pain was treated with intramuscular (IM)injections of opioids at intervals from 3 to 6 hours as needed.Avoid meperidine except for treatment of shivering or allergy to other opioids.Contraindications to NSAIDs are aspirin-sensitive asthma,bleeding,coagulopathy disorders,history of gastrointestinal bleeding,renal compromise,and hypovolemia.

Evidence Indicates That Early Analgesia Reduces Postoperative Problems