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Anesth Analg. 2017 Nov;125(5):1749-1760. doi: 10.1213/ANE.0000000000002497.

A Review of Opioid-Sparing Modalities in Perioperative Pain Management: Methods to Decrease Opioid Use Postoperatively.

Author information

1
From the *Department of Anesthesiology, Hospital for Special Surgery, New York; †Herzl Family Medicine Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; and ‡Department of Anesthesiology and Critical Care Medicine, the Johns Hopkins Hospital, Baltimore, Maryland.

Abstract

There is an epidemic of opioid use, abuse, and misuse in the United States, which results in significant morbidity and mortality. It may be difficult to reduce perioperative opioid use given known acute surgical trauma and resultant pain; however, the discrete and often limited nature of postoperative pain also may make management easier in part by utilizing nonopioid modalities, such as regional anesthesia/analgesia, and multimodal analgesia, which may decrease the need for powerful opioids. This article reviews the relevant literature describing the use of adjunct medications, regional anesthesia and analgesic techniques, and regional block additives in the context of providing adequate pain control while lessening opioid use.

PMID:
29049119
DOI:
10.1213/ANE.0000000000002497
[Indexed for MEDLINE]

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