Emerging Non-Opioid Analgesic Strategies in Total Joint Arthroplasty: Mechanisms, Evidence, and Practical Implementation - PubMed
10 hours ago
- #non-opioid analgesia
- #pain management
- #total joint arthroplasty
- Emerging non-opioid strategies for analgesia in total joint arthroplasty address the opioid crisis with multimodal approaches.
- New pharmacologic options include suzetrigine (Nav1.8 blocker), intravenous meloxicam (COX-2 inhibitor), and liposomal bupivacaine.
- Non-pharmacologic methods like TENS, acoustic-medicine ultrasound, and acupuncture help modulate pain pathways.
- Innovations include injectable hydrogel/polymer systems for sustained local analgesia beyond 72 hours.
- The NOPAIN Act (2025) incentivizes adoption through Medicare reimbursement for non-opioid treatments.
- Limitations to wider use include cost, access, and lack of arthroplasty-specific trials.
- Future directions involve AI for personalized regimens, predictive algorithms, and real-time pain monitoring.