Perioperative Pain Management and Avoidance of Long-term Opioid Use

Sports Medicine and Arthroscopy Review
Michael S Patzkowski, Jeanne C Patzkowski

Abstract

The opioid epidemic continues to be a problem in the United States and prescription opioid overdose fatalities continue to rise. Chronic opioid use threatens military readiness and puts service members at risk for medical separation from military service. Orthopedic surgeons commonly prescribe opioid medications for postsurgical patients. Long-term opioid use can be the result of acute, postoperative opioid intake. Overprescribing may increase the risk of long-term opioid use, medication diversion and adverse outcomes. Preoperative administration of opioids dramatically increases the risk of continued use up to 1 year after surgery. Strategies to minimize opioid use include opioid-specific preoperative counseling, multimodal analgesia with opioid-sparing oral and intravenous medications, regional anesthesia, minimizing tourniquet use, and preoperative behavioral health evaluation.

References

May 1, 1989·The Journal of Hand Surgery·A J Nitz, J J Dobner
Jul 1, 1982·The American Journal of Sports Medicine·J J Dobner, A J Nitz
Nov 1, 1996·The American Journal of Sports Medicine·R A ArcieroR J Snyder
Aug 29, 2001·Anesthesia and Analgesia·C MenigauxM Chauvin
Nov 28, 2002·Scandinavian Journal of Medicine & Science in Sports·Y KonishiD Takeshita
Apr 23, 2005·Anesthesia and Analgesia·Christophe MénigauxMarcel Chauvin
Apr 25, 2006·Journal of Geriatric Physical Therapy·Michael S RichardsonMichael G Bemben
Jun 20, 2006·Pain·Renan C CastilloUNKNOWN LEAP Study Group
Jul 25, 2006·Pharmacoepidemiology and Drug Safety·Leonard J PaulozziYongli Xi
Feb 23, 2008·Anesthesiology·Alain C Van ElstraeteDan Benhamou
Feb 28, 2008·The Journal of Trauma·Brett D OwensJohn B Holcomb
Dec 11, 2008·JAMA : the Journal of the American Medical Association·Aron J HallLeonard J Paulozzi
Jan 6, 2010·Regional Anesthesia and Pain Medicine·Michael J FredricksonAdam J Dalgleish
Mar 14, 2012·The Journal of Hand Surgery·Jeffrey RodgersEdward Finnerty
Aug 31, 2012·The Journal of the American Academy of Orthopaedic Surgeons·Jeanne C PatzkowskiJoseph C Wenke
Oct 26, 2012·The Journal of Bone and Joint Surgery. American Volume·Kethy M Jules- ElyseeThomas P Sculco
May 9, 2014·Pain Research & Management : the Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur·Chris RingwaltAsheley Cockrell Skinner
May 15, 2015·Regional Anesthesia and Pain Medicine·Richard BrullMichael J Barrington
Jul 21, 2015·Regional Anesthesia and Pain Medicine·Tim DwyerRichard Brull
Jul 21, 2015·Regional Anesthesia and Pain Medicine·Tim DwyerRichard Brull
Jul 21, 2015·Regional Anesthesia and Pain Medicine·Andrea VeljkovicRichard Brull
Nov 28, 2015·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Theodoros PapathanasiouTrine Meldgaard Lund
Dec 15, 2015·JAMA Internal Medicine·Jonathan H ChenAnna Lembke
Apr 14, 2016·Journal of Shoulder and Elbow Surgery·Andrew P DekkerJomy Kurian
Jun 29, 2016·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Kelechi R OkorohaVasilios Moutzouros
Jul 9, 2016·MMWR Supplements·Thomas R Frieden
Dec 14, 2016·The New England Journal of Medicine·Steven E NissenUNKNOWN PRECISION Trial Investigators
Jan 10, 2017·Anesthesia and Analgesia·Rakesh V Sondekoppam, Ban C H Tsui
Mar 17, 2017·MMWR. Morbidity and Mortality Weekly Report·Anuj ShahBradley C Martin
Jun 3, 2017·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Robert W WestermannBrian R Wolf

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Citations

Aug 8, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Tracy M FlandersZarina S Ali
Aug 5, 2020·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Melissa A Kluczynski
Nov 9, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Paul M JeziorczakCharles J Aprahamian

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