ropivacaine + morphine + flurbiprofen + epinephrine

A multimodal analgesic cocktail developed by Peking Union Medical College Hospital for periarticular infiltration during total knee arthroplasty in patients with osteoarthritis. The mixture contains ropivacaine (a local anesthetic), morphine (an opioid), flurbiprofen (an NSAID), and epinephrine (a vasoconstrictor). This combination is designed to provide localized, long-lasting pain relief by targeting multiple pain pathways: ropivacaine blocks sodium channels to inhibit nerve conduction, morphine activates mu-opioid receptors, flurbiprofen inhibits cyclooxygenase enzymes to reduce inflammation, and epinephrine prolongs the local effect by inducing vasoconstriction. It is administered directly into the surgical site (periarticular and intraarticular) to improve postoperative recovery and reduce the need for systemic opioids.

Other names

periarticular infiltration-Peking Union Medical College Hospital-osteoarthritisperiarticular infiltrationPAI cocktailmultimodal periarticular injection