Perioperative Pain Management and Opioid Stewardship: A Practical Guide

Perioperative Pain Management and Opioid Stewardship: A Practical Guide

Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehe...

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Bibliographic Details
Published in:Healthcare (Basel) Vol. 9; no. 3; p. 333
Main Authors: Hyland, Sara J, Brockhaus, Kara K, Vincent, William R, Spence, Nicole Z, Lucki, Michelle M, Howkins, Michael J, Cleary, Robert K
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 16-03-2021
MDPI
Subjects:
Analgesics
Delirium
Drug use
Heroin
Morphine
multimodal analgesia
Narcotics
opioid stewardship
Optimization
Pain management
Patients
perioperative care
postoperative pain
Quality of life
Recovery (Medical)
regional anesthesia
Review
Surgery
Surgical outcomes
United States > US
opioid-related adverse effects
transitions of care
opioid stewardship
multimodal analgesia
postoperative pain
perioperative care
regional anesthesia
perioperative medication management
pain management
preemptive analgesia
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Summary:Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehensive integration of these recommendations into standard practice at the institutional level remains elusive, and persistent postoperative pain and opioid use pose significant societal burdens. The multitude of guidance publications, many different healthcare providers involved in executing them, evolution of surgical technique, and complexities of perioperative care transitions all represent challenges to process improvement. This review seeks to summarize and integrate key recommendations into a "roadmap" for institutional adoption of perioperative analgesic and opioid optimization strategies. We present a brief review of applicable statistics and definitions as impetus for prioritizing both analgesia and opioid exposure in surgical quality improvement. We then review recommended modalities at each phase of perioperative care. We showcase the value of interprofessional collaboration in implementing and sustaining perioperative performance measures related to pain management and analgesic exposure, including those from the patient perspective. Surgery centers across the globe should adopt an integrated, collaborative approach to the twin goals of optimal pain management and opioid stewardship across the care continuum.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
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ISSN:2227-9032
2227-9032
DOI:10.3390/healthcare9030333