Emerging Nonopioid Analgesic Strategies in Total Joint Arthroplasty: Mechanisms, Evidence, and Practical Implementation
Abstract
BACKGROUND
Total joint arthroplasty (TJA), encompassing total hip and knee arthroplasty, remains one of the most effective procedures for end-stage arthritis, but is frequently associated with substantial postoperative pain. Opioid-based analgesia, although effective, carries risks of dependence, respiratory depression, and delayed recovery. In response to the opioid crisis, multimodal nonopioid strategies have gained prominence to improve outcomes while minimizing adverse effects.
METHODS
This review summarized current and emerging nonopioid analgesic modalities with clinical relevance to TJA. Recent randomized controlled trials, meta-analyses, and regulatory updates were analyzed to evaluate efficacy, safety, and practical integration into perioperative care.
RESULTS
Novel pharmacologic options-including suzetrigine (VX-548), a selective voltage-gated sodium 1.8 sodium channel blocker; intravenous meloxicam, a parenteral COX-2 inhibitor; and extended-release liposomal bupivacaine, demonstrate meaningful opioid-sparing effects with favorable tolerability profiles. Adjunctive nonpharmacologic modalities such as transcutaneous electrical nerve stimulation, sustained-acoustic-medicine ultrasound, and acupuncture offer complementary benefits by modulating peripheral and central sensitization. In addition, injectable hydrogel and polymer-based delivery systems represent a next generation of sustained local analgesia with the potential to extend pain control beyond 72 hours. The…
Read the paper
Related studies
- Noninvasive and Point-of-Care Surface-Enhanced Raman Scattering (SERS)-Based Breathalyzer for Mass Screening of Coronavirus Disease 2019 (COVID-19) under 5 min
- De Novo Transcriptome Analysis and Detection of Antimicrobial Peptides of the American Cockroach Periplaneta americana (Linnaeus)
- Molecular Characterization and Expression Profiling of Tomato GRF Transcription Factor Family Genes in Response to Abiotic Stresses and Phytohormones
- Assembly of Tight Junction Strands: Claudin-10b and Claudin-3 Form Homo Tetrameric Building Blocks that Polymerise in a Channel-Independent Manner
- Update of the Pompe variant database for the prediction of clinical phenotypes: Novel disease‐associated variants, common sequence variants, and results from newborn screening
- Machine Learning-Based SERS Chemical Space for Two-Way Prediction of Structures and Spectra of Untrained Molecules
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.