Abstract
Purpose of Review
This review aims to summarize interventions used in the perioperative period to reduce the development of new persistent postoperative opioid use in opioid-naïve patients.
Recent Findings
The development of new persistent opioid use after surgery has recently been identified as a common postoperative complication. The existing literature suggests that interventions across the continuum of care have been shown to decrease the incidence of new persistent postoperative opioid use. Specific preoperative, intraoperative, and postoperative interventions will be reviewed, as well as the use of clinical pathways and protocols that span throughout the perioperative period. Common to many of these interventions include the use of multimodal analgesia throughout the perioperative period and an emphasis on a patient-centered, evidence-based approach to the perioperative pain management plan.
Summary
While the incidence of new persistent postoperative opioid use appears to be high, the literature suggests that there are both small- and large-scale interventions that can be used to reduce this. Technological advances including prescription monitoring systems and mobile applications have enabled studies to monitor opioid consumption after discharge. Interventions that occur preoperatively, such as patient education and expectation setting regarding postoperative pain management, and interventions that occur postoperatively, such as the implementation of procedure-specific, evidence-based prescribing guidelines and protocols, have been shown to reduce post-discharge opioid consumption. The use of multimodal analgesia and opioid-sparing adjuncts throughout the perioperative period is central to many of these interventions and has essentially become standard of care for management of perioperative pain.
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Change history
05 November 2021
A Correction to this paper has been published: https://doi.org/10.1007/s11916-021-00990-z
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Stacey Burns, MD, MBA, Rachel Pian, BA, and Oscar Jim Michael Coppes, MD, have no conflicts of interest to disclose. Richard Urman, MD reports grants and personal fees from Merck, grants and personal fees from Medtronic, grants from AcelRx, personal fees from Takeda, personal fees from Heron, personal fees from Acacia, and grants from NIH/AHRQ/NSF, outside the submitted work.
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Burns, S., Urman, R., Pian, R. et al. Reducing New Persistent Opioid Use After Surgery: A Review of Interventions. Curr Pain Headache Rep 25, 27 (2021). https://doi.org/10.1007/s11916-021-00943-6
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DOI: https://doi.org/10.1007/s11916-021-00943-6