Format

Send to

Choose Destination
Expert Opin Pharmacother. 2019 Jun;20(8):949-961. doi: 10.1080/14656566.2019.1583743. Epub 2019 Feb 27.

State of the art opioid-sparing strategies for post-operative pain in adult surgical patients.

Author information

1
a Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain , University of California , San Diego, La Jolla , CA , USA.
2
b Division of Biomedical Informatics , University of California , San Diego, La Jolla , CA , USA.
3
c Outcomes Research Consortium , Cleveland , OH , USA.

Abstract

INTRODUCTION:

There are various important implications associated with poorly controlled postoperative pain in the adult surgical patient - this includes cardiopulmonary complications, opioid-related side effects, unplanned hospital admissions, prolonged hospital stay, and the subsequent development of chronic pain or opioid addiction. With the ongoing national opioid crisis, it is imperative that perioperative providers implement pathways for surgical patients that reduce opioid requirements and pain-related complications.

AREAS COVERED:

In this review, the authors discuss the components of a multimodal opioid-sparing analgesia pathway as it pertains to the perioperative environment. Medications reviewed include gabapentinoids, acetaminophen, non-steroidal anti-inflammatory drugs, ketamine, intravenous lidocaine, dexmedetomidine, and glucocorticoids. The use of peripheral nerve blocks and neuraxial analgesia are also discussed.

EXPERT OPINION:

In appropriate cases, regional anesthetic interventions are extremely useful for postoperative analgesia, including peripheral nerve blocks and neuraxial analgesia and while newer postoperative analgesics have been postulated, the literature on such is presently controversial. Coordinated approaches to pain management are recommended to reduce the need for opioids and to improve patient satisfaction post-surgery.

KEYWORDS:

Multimodal analgesia; acute pain service; opioid; perioperative

PMID:
30810425
DOI:
10.1080/14656566.2019.1583743
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Taylor & Francis
Loading ...
Support Center