Opioid free anesthesia: feasible?

Current Opinion in Anaesthesiology
Pamela A ChiaChristine C Myo Bui

Abstract

The present review aims to address the feasibility of opioid free anesthesia (OFA). The use of opioids to provide adequate perioperative pain management has been a central practice of anesthesia, and only recently has been challenged. Understanding the goals and challenges of OFA is essential as the approach to intraoperative analgesia and postsurgical management of pain has shifted in response to the opioid epidemic in the United States. OFA is an opioid sparing technique, which focuses on multimodal or balanced analgesia, relying on nonopioid adjuncts and regional anesthesia. Enhanced recovery after surgery protocols, often under the auspices of a perioperative pain service, can help guide and promote opioid reduced and OFA, without negatively impacting perioperative pain management or recovery. The feasibility of OFA is evident. However, there are limitations of this approach that warrant discussion including the potential for adverse drug interactions with multimodal analgesics, the need for providers trained in regional anesthesia, and the management of pain expectations. Additionally, minimizing opioid use perioperatively also requires a change in current prescribing practices. Monitors that can reliably quantify nocicept...Continue Reading

References

Jun 1, 1995·Clinical and Experimental Pharmacology & Physiology·R Kanjhan
Apr 28, 2004·Anesthesiology·Esperanza Ingersoll-WengPatricia A Thistlethwaite
Dec 22, 2005·Anesthesia and Analgesia·Jeffrey M RichmanChristopher L Wu
Dec 13, 2007·JAMA : the Journal of the American Medical Association·Pratik P PandharipandeE Wesley Ely
Jul 10, 2010·The American Journal of Pathology·Lisa KoodieSabita Roy
Dec 25, 2010·Therapeutische Umschau. Revue thérapeutique·Thilo Bertsche, Gerd Mikus
Oct 25, 2011·Anesthesiology·Ream Al-Hasani, Michael R Bruchas
Apr 26, 2012·Regional Anesthesia and Pain Medicine·Narinder Rawal
Aug 2, 2012·JAMA : the Journal of the American Medical Association·Lewis S Nelson, Jeanmarie Perrone
Jan 11, 2013·Journal of Pain & Palliative Care Pharmacotherapy·Gary M OderdaScott B Robinson
Apr 25, 2013·British Journal of Anaesthesia·T LedowskiN Parker
Apr 1, 2014·The New England Journal of Medicine·P J DevereauxUNKNOWN POISE-2 Investigators
May 13, 2014·Best Practice & Research. Clinical Anaesthesiology·Karina GritsenkoRichard D Urman
Aug 16, 2014·Acta Anaesthesiologica Scandinavica·J B DahlUNKNOWN Scandinavian Postoperative Pain Alliance (ScaPAlli)
May 21, 2015·American Society of Clinical Oncology Educational Book·Eduardo Bruera, Judith A Paice
Jan 1, 2016·MMWR. Morbidity and Mortality Weekly Report·Rose A RuddR Matthew Gladden
Mar 19, 2016·Current Opinion in Supportive and Palliative Care·Timothy Wigmore, Paul Farquhar-Smith
Dec 14, 2016·The New England Journal of Medicine·Vivek H Murthy
Mar 12, 2017·Current Pain and Headache Reports·Chris Cullom, Jonathan T Weed
Apr 14, 2017·JAMA Surgery·Chad M BrummettBrahmajee K Nallamothu
Jul 26, 2017·Anesthesia and Analgesia·Thomas R Vetter, Zeev N Kain
Sep 19, 2017·Scandinavian Journal of Pain·Mauricio ForeroKi Jinn Chin
Dec 15, 2018·Anesthesia and Analgesia·Girish P Joshi, Henrik Kehlet
Feb 28, 2019·Expert Opinion on Pharmacotherapy·Rodney A GabrielEngy T Said
May 3, 2019·British Journal of Anaesthesia·Thomas Ledowski
May 17, 2019·Anesthesiology·Glenn S Murphy, Joseph W Szokol
Jul 13, 2019·Current Pharmaceutical Design·Alfredo Malo-MansoJose L Guerrero-Orriach
Jul 19, 2019·Current Medical Research and Opinion·George J Nassif, Timothy E Miller
Dec 2, 2019·Best Practice & Research. Clinical Anaesthesiology·Juan P CataPascal Owusu-Agyemang

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Citations

Mar 14, 2021·British Journal of Anaesthesia·Felipe P RangelClaudia M Simões
Mar 30, 2021·Indian Journal of Anaesthesia·Lalit MehdirattaAbhijit Nair
Dec 24, 2021·Journal of Feline Medicine and Surgery·Paulo V SteagallSamantha Taylor

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