Advanced Pain Management

Alexander P. Sah

As successful as joint replacement is in restoring patient function, it has traditionally been limited by the post-surgery pain in recovery.  I have been driven to optimize patient outcomes by minimizing pain after surgery while also reducing medication side effects.  I have had a particular interest in developing special protocols, and lecturing and teaching about them at national meetings and conferences.

Multimodal pain management is the use of many different medications in smaller doses, with the goal of providing even better pain relief, with fewer side effects.  In particular, opioid reduction and its associated side effects is a key element of this multimodal technique.  Advancements such as this have allowed me to reduce hospital length of stay and speed patient recovery and to even develop my outpatient joint replacement program.  Partial knee replacement patients and anterior hip replacement patients often have minimal to no pain after surgery.  Even my major revision hip and knee replacement patients have benefited from these techniques and are able to go home within one day of surgery.

I have found this area of interest to be rewarding to both me and my patients.  I am often amazed at the rapid recovery and early return to activities achieved with these protocols.  The opportunities to speak as faculty at meetings and collaborate with my colleagues from across the country in this space allows me to bring the most advanced techniques back to my patients.  This is a constantly evolving process, and I remain dedicated to providing my patients optimal pain relief while minimizing side effects.

Presentations on Multimodal Pain Management
Alexander Sah, “Moving to the Outpatient Setting: Opioid-sparing multimodal protocols in total joint arthroplasty”
Presentation at Symposium, AAHKS, Dallas, 2017
Alexander Sah, “Optimizing Pain Management for Outpatient Joint Replacement”
Presentation at CA Orthopedic Assoc Annual Meeting, Carlsbad, 2017
Alexander Sah, “Blood and Pain Management in Modern Joint Replacement”
Presentation at Contemporary Solutions in Joint Surgery, Salt Lake City, 2017
Alexander Sah, “Multimodal Pain Management for Total Hip and Knee Arthroplasty Patients: Current Concepts and Controversies 2016”
Presentation at Symposium, AAHKS, Dallas, 2016
Alexander Sah, “Pain Management in Outpatient Total Joints”
Presentation at Road to Outpatient Joint Replacement Symposium, AAHKS, Dallas, 2016
Alexander Sah, “Pain Management in Total Hip Arthroplasty”
Presentation at West Regional Recon Hip and Knee Meeting, San Francisco, 2016
Alexander Sah, “Multimodal Pain Management in Total Joint Replacment- Experience with an Opioid-Sparing Approach”
Presentation at Opioid Reducing Multimodal Pain Strategy Consultant Meeting, Los Angeles, 2016
Alexander Sah, “Pain Management Strategies: Best Practices in Optimal Care”
Presentation at ICJR 3rd Annual Pan Pacific Orthopedic Congress, Kona, Hawaii, 2016
Alexander Sah, “Long Lasting Periarticular Injection- Optimizing Technique”
Presentation at 25th Annual California Orthopedic Association meeting, Laguna Niguel, 2016
Alexander Sah, “Optimizing Pain Management- to reduce the opioid burden”
Presentation at 4th Annual Utah Hip and Knee Arthroplasty Symposium, Deer Valley, 2016
Alexander Sah, “Advancements in Pain, Blood, DVT, and Wound Management for reducing length of stay”
Presentation and Moderator at Same Day Surgery Symposium, AAHKS, Dallas, 2015
Alexander Sah, “Enhancements in Pain Management- For Reducing Length of Stay”
Presentation and Moderator at VuMedi Webinar- Reducing Recovery Time in Total Joint Arthroplasty, 2015
Alexander Sah, “The Use of Multimodal Analgesia in Treating Acute Pain”
Presentation at HANA Annual Meeting- Oahu, 2015
Alexander Sah, “Multimodal Pain Management for Acute Pain- A Focus on Patient Care”
Presentation at Symposium ICJR West Meeting, Napa, 2015
Alexander Sah, “Novel Techniques for Managing Postoperative Pain for Procedures Performed in the Hospital and Ambulatory Setting.”
Presentation at ICJR Webcast, 2015
Alexander Sah, “The Use of Multimodal Analgesia in Treating Acute Pain: A Focus on Patient Care, Importance of Patient Experience of Care in the Hospital Setting.”
Presentation at ICJR Webinar, 2015
Alexander Sah, “Managing Pain in Total Joint Replacement with a Novel Long-Lasting Injectable”
Presentation at 3rd Annual VuMedi- The Event, San Francisco, 2014
Alexander Sah, “A Novel Periarticular Injection for Improved Pain Control after Joint Replacement"
Presentation at Symposium Western Orthopedic Association Meeting, Kona, 2014
Alexander Sah, “Use of Exparel, a long-acting bupivicaine, for improved pain control in total knee arthroplasty”
Presentation at Outpatient Arthroplasty Meeting, Kirkland, 2014

Publications and Committees on Pain Management Advances

Sah Alexander, Liang K, Sclafani J. Optimal Multimodal Analgesia Protocols for Total Joint Arthroplasty: A Critical Review. JBJS Reviews, 2017

Sah Alexander, Warren L. Liposomal Bupivacaine: Market Penetration vs Scientific Evidence: Only the Facts. Techinques in Orthopaedics, 2017

Sah Alexander. Multimodal Pain Management in Knee Revision Surgery. Anesthesiology News/General Surgery News, June 2016

Sah Alexander, Bollinger A. The role of multimodal analgesia in Orthopedic surgery. 2015

Chair, Pain Management ASC Task Force, CA Orthopedic Association, 2017-19

Principal Investigator, Steering Committee, Exparel TKA Wound Infiltration RCT, 2016-7