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Non-opioid Adjuncts and Alternatives

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Perioperative Pain Control: Tools for Surgeons

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Abstract

Periprocedural use of opioid-containing agents by medical providers is a practice that continues to shape the US opioid crisis. Consensus guidelines recommend reduction of opioid use whenever possible. Numerous alternative non-opioid analgesic agents exist to replace the sole use of opioids with multimodal analgesia. Data supports the use of adjuvant non-opioid analgesic agents that offer opioid-sparing action and reduce the occurrence of postoperative side effects. Commonly used analgesics include nonsteroidal anti-inflammatory drugs, acetaminophen, gabapentinoids, N-methyl-D-aspartate antagonists, and alpha-2 adrenergic agonists. Procedure type, facility setting, and patient-specific factors dictate which non-opioid alternative and adjunct agents are appropriate. Incorporation of these agents is likely to increase over time due to improved patient recovery times, reduced reliance on opioids, and minimized procedural costs.

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Author information

Authors and Affiliations

  1. Summit Medical Group, Pharmacy Services, Berkeley Heights, NJ, USA

    Erin Maggie Jones

  2. Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA

    Gregory L. Barinsky

  3. Department of Anesthesiology, Division of Pain Medicine, Columbia University Irving Medical Center, New York, NY, USA

    Anna A. Pashkova

  4. Bergen Medical Associates, Emerson, NJ, USA

    Peter F. Svider

  5. Hackensack Meridian Health, Hackensack University Medical Center, Hackensack, NJ, USA

    Peter F. Svider

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  1. Erin Maggie Jones
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  2. Gregory L. Barinsky
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  3. Anna A. Pashkova
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  4. Peter F. Svider
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Editor information

Editors and Affiliations

  1. Bergen Medical Associates, Emerson, NJ, USA

    Peter F. Svider

  2. Anesthesiology, Pain Medicine, Columbia University Irving Medical Center, New York, NY, USA

    Anna A. Pashkova

  3. Otolaryngology – Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Andrew P. Johnson

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Jones, E.M., Barinsky, G.L., Pashkova, A.A., Svider, P.F. (2021). Non-opioid Adjuncts and Alternatives. In: Svider, P.F., Pashkova, A.A., Johnson, A.P. (eds) Perioperative Pain Control: Tools for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-030-56081-2_6

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  • DOI: https://doi.org/10.1007/978-3-030-56081-2_6

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