文章基本信息

标题：Perioperative Pain Management and Opioid Stewardship: A Practical Guide
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作者：Sara J. Hyland ; Kara K. Brockhaus ; William R. Vincent 等
期刊名称：Healthcare
电子版ISSN：2227-9032
出版年度：2021
卷号：9
期号：3
页码：333
DOI：10.3390/healthcare9030333
出版社：MDPI Publishing
摘要：Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehensive integration of these recommendations into standard practice at the institutional level remains elusive, and persistent postoperative pain and opioid use pose significant societal burdens. The multitude of guidance publications, many different healthcare providers involved in executing them, evolution of surgical technique, and complexities of perioperative care transitions all represent challenges to process improvement. This review seeks to summarize and integrate key recommendations into a “roadmap” for institutional adoption of perioperative analgesic and opioid optimization strategies. We present a brief review of applicable statistics and definitions as impetus for prioritizing both analgesia and opioid exposure in surgical quality improvement. We then review recommended modalities at each phase of perioperative care. We showcase the value of interprofessional collaboration in implementing and sustaining perioperative performance measures related to pain management and analgesic exposure, including those from the patient perspective. Surgery centers across the globe should adopt an integrated, collaborative approach to the twin goals of optimal pain management and opioid stewardship across the care continuum.
关键词：pain management; opioid stewardship; perioperative care; postoperative pain; multimodal analgesia; regional anesthesia; preemptive analgesia; perioperative medication management; transitions of care; opioid-related adverse effects pain management ; opioid stewardship ; perioperative care ; postoperative pain ; multimodal analgesia ; regional anesthesia ; preemptive analgesia ; perioperative medication management ; transitions of care ; opioid-related adverse effects