Mitigating and preventing perioperative opioid-related harm.


Journal

Current opinion in anaesthesiology
ISSN: 1473-6500
Titre abrégé: Curr Opin Anaesthesiol
Pays: United States
ID NLM: 8813436

Informations de publication

Date de publication:
12 Aug 2024
Historique:
medline: 9 9 2024
pubmed: 9 9 2024
entrez: 9 9 2024
Statut: aheadofprint

Résumé

Although necessary for treatment of acute pain, opioids are associated with significant harm in the perioperative period and further intervention is necessary perioperatively to mitigate opioid-related harm. Opioid-naive patients are often first exposed to opioids when undergoing surgery, which can result in significant harm. Despite their benefits in reducing acute postsurgical pain, they are also associated with risks ranging from mild (e.g., pruritis, constipation, nausea) to potentially catastrophic (e.g. opioid-induced ventilatory impairment, respiratory depression, death). Overprescribing of opioids can lead to opioid diversion and drug driving. In this review, we will discuss opioid-related harm and what strategies can be used perioperatively to mitigate this harm. Interventions such as optimizing nonopioid analgesia, implementing Enhanced Recovery after Surgery programs, effective respiratory monitoring, patient education and opioid stewardship programs will be discussed. We will review policy and guidelines regarding perioperative opioid management and identify challenges and future directions to mitigate opioid-related harm.

Identifiants

pubmed: 39247993
doi: 10.1097/ACO.0000000000001426
pii: 00001503-990000000-00225
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Auteurs

Monica W Harbell (MW)

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona.

Jonathan Cohen (J)

Department of Anesthesiology, Moffitt Cancer Center, Tampa, Florida.

Greg Balfanz (G)

Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina.

Emily Methangkool (E)

Department of Anesthesiology, Olive View-UCLA Medical Center, Los Angeles, California, USA.

Classifications MeSH