Dr. John Gerancher: Fighting Pain Using Multimodal Analgesia

A former professor at the departments of anesthesiology at Wake Forest School of Medicine and Stanford University School of Medicine, Dr. John Charles “JC” Gerancher has extensive experience promoting evidence-based solutions that anesthesiologists can use to improve patient care.

Recently, anesthesiologists have begun utilizing multimodal approaches to the administration of analgesic treatments, a method of pain management that prioritizes the use of specific combinations of drugs rather than prioritizing a single treatment. This approach has generally resulted in better patient outcomes by reducing the negative side effects of traditional analgesic regimens and better controlling pain before and after surgery.

Most anesthesiologists have prioritized the use of opioids like morphine in managing pain, but these drugs have well known adverse effects. The multimodal approach to analgesia involves introducing other drug treatments, including nonsteroidal antiinflammatory drugs (NSAIDs), paracetamol, local anesthetics, and adjuvants. Research has found that by using multiple drugs, ideally three or more, in the treatment of pain, analgesia is improved markedly in both perioperative and postoperative settings. While this approach has not become fully mainstream, with fewer than 25 percent of physicians providing multimodal treatments prior to surgery, pain specialists throughout the country are striving to ensure that anesthesiologists are informed about the benefits of combining analgesic treatments.