CHSU Discovery

Abstract

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Arthroscopy is a minimally invasive orthopedic procedure that allows joint visualization and treatment through minimally invasive orthopedic procedure that allows joint visualization and treatment through minimally invasive orthopedic procedure that allows joint visualization and treatment through small incisions.
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Opioids have traditionally been the primary modality for postoperative pain control in orthopedic surgery due to their strong analgesic effects. However, they are associated with significant risks, including respiratory depression, dependence, and overdose. These risks contribute to opioids being a leading cause of preventable death in the United States.
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Postoperative analgesia can be broadly divided into opioid and nonopioid strategies, which differ in both mechanism and risk profile. Opioids act centrally through mu-opioid receptor activation, suppressing nociceptive signaling. While effective, their side effect profile limits their desirability as a first-line option.
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Nonopioid analgesics, including NSAIDs, local anesthetics, and gabapentinoids, target pain through multiple peripheral and central mechanisms. These agents reduce inflammation, inhibit nerve conduction, and decrease excitatory neurotransmitter release. Their diverse mechanisms support the use of multimodal pain control approaches.
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The ongoing opioid epidemic and prescribing concerns, particularly among orthopedic surgeons, have driven interest in opioid-sparing strategies. However, there remains limited literature directly comparing nonopioid and opioid protocols in arthroscopic surgery. This highlights the need for further evaluation of multimodal, nonopioid approaches to optimize outcomes and reduce opioid dependence