bupivacaine + lidocaine + morphine + epinephrine + ketorolac

This multimodal perioperative pain management protocol was developed and evaluated by the Northern Orthopaedic Division in Denmark for patients undergoing circumferential lumbar fusion surgery. The regimen, referred to as "local anaesthesia" in the context of the clinical trial NCT00463112, consists of a comprehensive combination of analgesics administered through multiple routes. It includes preemptive and postoperative local infiltration with bupivacaine, preemptive epidural analgesia using lidocaine and morphine, followed by a 72-hour continuous postoperative epidural infusion of bupivacaine, morphine, and epinephrine. Additionally, intravenous ketorolac is administered after wound closure. This integrated approach is designed to facilitate "fast-track" recovery by optimizing pain control, reducing the need for standard postoperative opioids, and enhancing early mobilization and rehabilitation.

Other names

Multimodal Perioperative Pain Management (Northern Orthopaedic Division)Fast-track rehabilitation program (Northern Orthopaedic Division)