Donna-Ann Thomas1, Praba Boominathan1, Jyotsna Goswami2, Sudipta Mukherjee2, Nalini Vadivelu3. 1. Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street TMP 3, New Haven, CT, 06520, USA. 2. Department of Anesthesiology & Critical Care, Tata Medical Center Kolkata, Kolkata, India. 3. Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street TMP 3, New Haven, CT, 06520, USA. nalini.vadivelu@yale.edu.
Abstract
PURPOSE OF REVIEW: With the rise of the opioid epidemic, anesthesiologists will find themselves faced with opioid-addicted patients more frequently. Addiction to opioids may also occur concurrently with abuse of other non-opioid medications. Our review article seeks to outline an armamentarium of pain management strategies in the perioperative period for these patients with addiction to opioid and non-opioid medications. RECENT FINDINGS: Statistics from the CDC demonstrate a shocking increase in opioid prescription rates and opioid-related deaths. Furthermore, opioid-addicted patients have notoriously undertreated pain in the perioperative period. A multitude of strategies are available in the perioperative period to treat pain in these patients. Formulating treatment plans for opioid and non-opioid-addicted patients undergoing surgery should include considerations in the pre-, intra-, and post-operative period. Our review article outlines several non-opioid modalities which may be employed to treat pain in these patients; however, particularly in the opioid-addicted population, the practitioner must be aware that non-opioids alone may not suffice to treat post-surgical pain. Consultation with pain management may be warranted to optimize opioid and non-opioid treatment for these patients.
PURPOSE OF REVIEW: With the rise of the opioid epidemic, anesthesiologists will find themselves faced with opioid-addictedpatients more frequently. Addiction to opioids may also occur concurrently with abuse of other non-opioid medications. Our review article seeks to outline an armamentarium of pain management strategies in the perioperative period for these patients with addiction to opioid and non-opioid medications. RECENT FINDINGS: Statistics from the CDC demonstrate a shocking increase in opioid prescription rates and opioid-related deaths. Furthermore, opioid-addictedpatients have notoriously undertreated pain in the perioperative period. A multitude of strategies are available in the perioperative period to treat pain in these patients. Formulating treatment plans for opioid and non-opioid-addictedpatients undergoing surgery should include considerations in the pre-, intra-, and post-operative period. Our review article outlines several non-opioid modalities which may be employed to treat pain in these patients; however, particularly in the opioid-addicted population, the practitioner must be aware that non-opioids alone may not suffice to treat post-surgical pain. Consultation with pain management may be warranted to optimize opioid and non-opioid treatment for these patients.
Entities:
Keywords:
Opioid addiction and surgery; Perioperative pain management
Authors: Edwin N Aroke; Susan P McMullan; Katie O Woodfin; Ryan Richey; Jordan Doss; Bryan A Wilbanks Journal: J Perianesth Nurs Date: 2020-07-11 Impact factor: 1.084