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Kaplunov O.A.

Volgograd State Medical University, Volgograd, Russia;
Multidisciplinary Medical Center, Volgograd, Russia

Gaponov E.S.

Multidisciplinary Medical Center, Volgograd, Russia

Kaplunov K.O.

Volgograd State Medical University, Volgograd, Russia;
Multidisciplinary Medical Center, Volgograd, Russia

Multimodal analgesia strategy in traumatology and orthopedics: a clinical case illustrating the effectiveness of the original protocol for postoperative pain relief

Authors:

Kaplunov O.A., Gaponov E.S., Kaplunov K.O.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2026;(4): 54‑61

DOI: 10.17116/hirurgia202604154

Read: 469 times

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Table of contents

MULTIMODAL ANALGESIA STRATEGY IN TRAUMATOLOGY AND ORTHOPEDICS: A CLINICAL CASE ILLUSTRATING THE EFFECTIVENESS OF THE ORIGINAL PROTOCOL FOR POSTOPERATIVE PAIN RELIEF
MULTIMODAL ANALGESIA STRATEGY IN TRAUMATOLOGY AND ORTHOPEDICS: A CLINICAL CASE ILLUSTRATING THE EFFECTIVENESS OF THE ORIGINAL PROTOCOL FOR POSTOPERATIVE PAIN RELIEF

To cite this article:

Kaplunov OA, Gaponov ES, Kaplunov KO. Multimodal analgesia strategy in traumatology and orthopedics: a clinical case illustrating the effectiveness of the original protocol for postoperative pain relief. Pirogov Russian Journal of Surgery. 2026;(4):54‑61. (In Russ.)
https://doi.org/10.17116/hirurgia202604154

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
Abstract:

This article presents a clinical case demonstrating the feasibility of using a combination of diclofenac and orphenadrine for adequate pain relief in a multimodal analgesia regimen in the early postoperative period. It also provides an overview of pain relief options used after major orthopedic and trauma surgeries in both domestic and international routine clinical practice. A unique local postoperative pain management protocol, developed taking into account the authors’ capabilities and preferences, is proposed.

Keywords:

postoperative analgesia
analgesia in traumatology and orthopedics
multimodal analgesia in traumatology
postoperative pain management protocol in traumatology
fixed-dose combination of diclofenac and orphenadrine

Authors:

Kaplunov O.A.

Volgograd State Medical University, Volgograd, Russia;
Multidisciplinary Medical Center, Volgograd, Russia

Gaponov E.S.

Multidisciplinary Medical Center, Volgograd, Russia

Kaplunov K.O.

Volgograd State Medical University, Volgograd, Russia;
Multidisciplinary Medical Center, Volgograd, Russia

Received:

20.01.2026

Accepted:

30.01.2026

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References:

  1. Borsodi M, Nagy E, Darvas K. Diclofenac/orphenadrine as a combined analgetic in post-operative relief of pain. Orv Hetil. 2008;149 (39):1847-1852. https://doi.org/10.1556/OH.2008.28419
  2. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, Carter T, Cassidy CL, Chittenden EH, Degenhardt E, et al. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131-157.  https://doi.org/10.1016/j.jpain.2015.12.008.Erratumin:JPain.2016;17(4):508-510.https://doi.org/10.1016/j.jpain.2016.02.002
  3. Elmallah RK, Chughtai M, Khlopas A, Newman JM, Stearns KL, Roche M, Kelly MA, Harwin SF, Mont MA. Pain Control in Total Knee Arthroplasty. J Knee Surg. 2018;31(6):504-513.  https://doi.org/10.1055/s-0037-1604152
  4. Elmallah RK, Cherian JJ, Pierce TP, Jauregui JJ, Harwin SF, Mont MA. New and Common Perioperative Pain Management Techniques in Total Knee Arthroplasty. J Knee Surg. 2016;29(2):169-178.  https://doi.org/10.1055/s-0035-1549027
  5. Wainwright TW, Gill M, McDonald DA, Middleton RG, Reed M, Sahota O, Yates P, Ljungqvist O. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Acta Orthop. 2020;91(1):3-19.  https://doi.org/10.1080/17453674.2019.1683790.Epub2019Oct30.Updatein:ActaOrthop.2020;91(3):363.https://doi.org/10.1080/17453674.2020.1724674
  6. Godoy Monzón D, Vazquez J, Jauregui JR, Iserson KV. Pain treatment in post-traumatic hip fracture in the elderly: regional block vs. systemic non-steroidal analgesics. Int J Emerg Med. 2010;3(4):321-325.  https://doi.org/10.1007/s12245-010-0234-4
  7. Mariano ER, Dickerson DM, Szokol JW, Harned M, Mueller JT, Philip BK, Baratta JL, Gulur P, Robles J, Schroeder KM, et al. A multisociety organizational consensus process to define guiding principles for acute perioperative pain management. Reg Anesth Pain Med. 2022;47(2):118-127.  https://doi.org/10.1136/rapm-2021-103083.Epub2021Sep22.PMID:34552003.
  8. Clinical Guidelines «Proximal Femoral Fractures». Moscow: Ministry of Health of the Russian Federation; 2025. (In Russ.).
  9. Ventafridda V, Tamburini M, Caraceni A, De Conno F, Naldi F. A validation study of the WHO method for cancer pain relief. Cancer. 1987;59(4):850-856.  https://doi.org/10.1002/1097-0142(19870215)59:4<850::aid-cncr2820590432>3.0.co;2-1
  10. Gukalov AA, Klypa TV, Mandel IA, Minets AI. The use of a fixed combination of diclofenac and orphenadrine for postoperative pain relief in orthopedic patients. Pirogov Russian Journal of Surgery. 2023;4:49-54. (In Russ.). https://doi.org/10.17116/hirurgia202304149
  11. Freys SM, Pogatzki-Zahn E. Pain therapy to reduce perioperative complications. Innov Surg Sci. 2019;4(4):158-166.  https://doi.org/10.1515/iss-2019-0008
  12. van Boekel RLM, Warlé MC, Nielen RGC, et al. Relationship Between Postoperative Pain and Overall 30-Day Complications in a Broad Surgical Population: An Observational Study. Ann Surg. 2019; 269(5):856-865.  https://doi.org/10.1097/SLA.0000000000002583
  13. Turan A, Leung S, Bajracharya GR, Babazade R, Barnes T, Schacham YN, Mao G, Zimmerman N, Ruetzler K, Maheshwari K, Esa WAS, Sessler DI. Acute Postoperative Pain Is Associated With Myocardial Injury After Noncardiac Surgery. Anesth Analg. 2020;131(3):822-829.  https://doi.org/10.1213/ANE.0000000000005033
  14. Helden EV, Kranendonk J, Vermulst A, Boer A, Reuver P, Rosman C, Wilt J, Laarhoven KV, Scheffer GJ, Keijzer C, Warlé M. Early postoperative pain and 30-day complications following major abdominal surgery: a retrospective cohort study. Reg Anesth Pain Med. 2025;50(8):651-657.  https://doi.org/10.1136/rapm-2024-105277
  15. Hernandez-Boussard T, Graham LA, Desai K, et al. The Fifth Vital Sign: Postoperative Pain Predicts 30-day Readmissions and Subsequent Emergency Department Visits. Ann Surg. 2017;266(3):516-524.  https://doi.org/10.1097/SLA.0000000000002372
  16. Vaurio LE, Sands LP, Wang Y, Mullen EA, Leung JM. Postoperative delirium: the importance of pain and pain management. Anesth Analg. 2006;102(4):1267-1273. https://doi.org/10.1213/01.ane.0000199156.59226.af
  17. Málek J, Nedělová I, Lopourová M, Stefan M, Kostál R. Diklofenak 75 mg s orfenadinem 30 mg (NEODOLPASSE) versus placebo a piroxikam v pooperacní analgezii u artroskopií [Diclofenac 75mg. and 30 mg. orfenadine (Neodolpasse) versus placebo and piroxicam in postoperative analgesia after arthroscopy]. Acta Chir Orthop Traumatol Cech. 2004;71(2):80-83. PMID: 15151094. (In Czech).
  18. Sorokina LS, Vyzhigina MA, Semenkov MA, Arkhipova OV, Eremenko AA. Fixed combination of diclofenac and orphenadrine (Neodolpasse) for postoperative pain relief. Review of the results of international and Russian studies. Russian Journal of Anesthesiology and Reanimatology. 2024;3:74-80. (In Russ.). https://doi.org/10.17116/anaesthesiology202403174
  19. Kiselev DV, Lavrukhin VV. The use of a fixed combination of diclofenac and orphenadrine in the treatment of acute pain syndrome in patients with discogenic lumbosacral radiculopathy and lumboischialgia. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(3):122-129. (In Russ.). https://doi.org/10.17116/jnevro2023123031122
  20. Eremenko AA, Sorokina LS, Ryabova DV, Urbanov AV. Analgesic and opioid-sparing effects of a fixed combination of diclofenac and orphenadrine in the early postoperative period in cardiac surgery patients. S.S. Korsakov Journal of Neurology and Psychiatry. 2022; 122(10):109-115. (In Russ.). https://doi.org/10.17116/jnevro2022122101109
  21. Semenkov AV, Bogdanov-Berezovsky AA, Skugarev AL, Tulskikh DA. Use of a fixed combination of diclofenac and orphenadrine (Neodolpasse) for postoperative analgesia after extended gastrectomy with resection of the lower third of the esophagus. P.A. Herzen Journal of Oncology. 2025;14(2):52-56. (In Russ.). https://doi.org/10.17116/onkolog20251402152
  22. Eremenko AA, Polushin YuS, Klypa TV, et al. Expert council resolution on the intermediate results of observational study «Efficacy and safety of Neodolpasse in early postoperative period». Russian Journal of Pain. 2023;21(1):85-87. (In Russ.). https://doi.org/10.17116/pain20232101185
  23. Fritsch G, Steltzer H, Oberladstaetter D, et al. Artificial intelligence algorithms predict the efficacy of analgesic cocktails prescribed after orthopedic surgery. PLoS One. 2023;18(2):e0280995. https://doi.org/10.1371/journal.pone.0280995
  24. Gupta A, Bah M. NSAIDs in the treatment of postoperative pain. Curr Pain Headache Rep. 2016;20(11):62.  https://doi.org/10.1007/s11916-016-0591-7
  25. Levy N, Mills P, Rockett M. Post-surgical pain management: time for a paradigm shift. British Journal of Anaesthesia. 2019;123(2):182-186.  https://doi.org/10.1016/j.bja.2019.05.031
  26. Rawal N. Current issues in postoperative pain management. Eur J Anaesthesiol. 2016;33:160-171.  https://doi.org/10.1097/EJA.0000000000000366
  27. Tay HP, Wang X, Narayan SW, Penm J, Patanwala AE. Persistent postoperative opioid use after total hip or knee arthroplasty: A systematic review and meta-analysis. Am J Health Syst Pharm. 2022;79(3):147-164.  https://doi.org/10.1093/ajhp/zxab367
  28. Zeiner S, Haider T, Zotti O, et al. Intravenous diclofenac and orphenadrine for the treatment of postoperative pain after remifentanil-based anesthesia: A double-blinded, randomized, placebo-controlled study [published online ahead of print, 2022 Dec 28]. Wien Klin Wochenschr. 2022. https://doi.org/10.1007/s00508-022-02131-x
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