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

Expert Opinion on Pharmacotherapy
Rodney A GabrielEngy T Said

Abstract

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. 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. 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 recommend...Continue Reading

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Citations

May 18, 2019·Pain Management·Rodney A GabrielBrian M Ilfeld
Jul 19, 2019·Current Medical Research and Opinion·George J Nassif, Timothy E Miller
Dec 7, 2019·Anesthesiology·Tobias SchneiderWilhelm Ruppen
Mar 3, 2020·Minerva anestesiologica·Franco CavaliereDavid Turnbull
Jun 13, 2020·Current Opinion in Anaesthesiology·Pamela A ChiaChristine C Myo Bui
Aug 5, 2020·Expert Review of Neurotherapeutics·Joseph V PergolizziFlaminia Coluzzi
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Sep 23, 2020·Minerva anestesiologica·Ece Yamak Altinpulluk, Alparslan Turan
Jan 16, 2021·Expert Review of Medical Devices·Rodney A Gabriel, Brian M Ilfeld
Jan 27, 2021·Nursing·Taylor Barnett, Linda Denke
Apr 4, 2021·Healthcare·Sara J HylandRobert K Cleary
May 8, 2021·Expert Review of Medical Devices·John J Finneran Iv, Brian M Ilfeld
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Aug 5, 2021·Praxis·Hagen BombergUrs Eichenberger
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