Approach to pain management in chronic opioid users undergoing orthopaedic surgery. J Am Acad Orthop Surg 2014 Oct;22(10):614-22
Date
10/05/2014Pubmed ID
25281256DOI
10.5435/JAAOS-22-10-614Scopus ID
2-s2.0-84923700362 (requires institutional sign-in at Scopus site) 43 CitationsAbstract
Opioids are commonly used for the management of pain in patients with musculoskeletal disorders; however, national attention has highlighted the potential adverse effects of the use of opioid analgesia in this and other nonmalignant pain settings. Chronic opioid users undergoing orthopaedic surgery represent a particularly challenging patient population in regard to their perioperative pain control and outcomes. Preoperative evaluation provides an opportunity to estimate a patient's preoperative opioid intake, discuss pain-related fears, and identify potential psychiatric comorbidities. Patients using high levels of opioids may also require referral to an addiction specialist. Various regional blockade and pharmaceutical options are available to help control perioperative pain, and a multimodal pain management approach may be of particular benefit in chronic opioid users undergoing orthopaedic surgery.
Author List
Devin CJ, Lee DS, Armaghani SJ, Bible J, Shau DN, Martin PR, Ehrenfeld JMAuthor
Jesse Ehrenfeld MD, MPH Sr Assoc Dean, Exec Director, Professor in the Advancing a Healthier Wisconsin Endowment department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Analgesics, OpioidAnesthesia, Conduction
Anti-Inflammatory Agents, Non-Steroidal
Humans
Orthopedic Procedures
Pain Management
Pain, Postoperative
Psychology
