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Non-narcotic Anesthetic Options for the Patient in Recovery from Substance Abuse

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Perioperative Addiction

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Abstract

While there is extensive literature regarding anesthesia for the actively addicted patient, there remains very little to guide the perioperative management of the patient in recovery. Developing a better understanding of the unique needs of the patient presenting for surgery who is in recovery from chemical dependency is essential for those involved in the perioperative care of such patients. Some of the issues that arise in this population are similar to those that confound the management of the chronic pain patient, such as tolerance, opioid-induced hyperalgesia, and withdrawal. In addition, many patients in recovery are maintained on methadone and buprenorphine, which can further complicate their perioperative management. This chapter will discuss pain management strategies involving alternatives to opiates, recommendations for safe use of opiates and other “triggering” agents, and relapse prevention. For the purpose of this discussion, the term “addict” will include persons addicted to alcohol.

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Notes

  1. 1.

    National Institute on Drug Abuse (NIDA) 2008 InfoFacts: Nationwide trends. Available online at: http://www.drugabuse.gov/infofacts/nationtrends.html accessed 09-18-2010.

  2. 2.

    Substance Abuse and Mental Health Services Administration (SAMHSA) Office of Applied Studies; participation in self-help groups for alcohol and illicit drug use, 2006–2007. Available online at: http://www.oas.samhsa.gov/2k8/selfHelp/selfHelp.cfm accessed 09-18-2010.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Los Angeles County Medical Center, University of Southern California, Los Angeles, CA, USA

    Heather Hamza MS, CRNA

Authors
  1. Heather Hamza MS, CRNA
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Correspondence to Heather Hamza MS, CRNA .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Mount Sinai School of Medicine, Associate Professor, New York, 10029, New York, USA

    Ethan O. Bryson

  2. Department of Anesthesiology, Mount Sinai School of Medicine, Professor, New York, 10029, New York, USA

    Elizabeth A. M. Frost

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Hamza, H. (2012). Non-narcotic Anesthetic Options for the Patient in Recovery from Substance Abuse. In: Bryson, E., Frost, E. (eds) Perioperative Addiction. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0170-4_16

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  • DOI: https://doi.org/10.1007/978-1-4614-0170-4_16

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-0169-8

  • Online ISBN: 978-1-4614-0170-4

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