Reducing Postoperative Opioid Overuse

Reducing Postoperative Opioid Overuse

Standard postoperative pain management involves extensive use of opioid analgesics, the overprescribing of which is an epidemic in the US.1 The American Academy of Orthopaedic Surgeons has called for reduced opioid prescribing as part of an overall culture change.2 And both the AAOS and the American Pain Society support the use of multimodal regimens in dealing with postoperative pain.2-3 Yet, despite the known shortcomings of opioids and the growing problem of overprescribing, they remain a key component of traditional postoperative pain management.1,4-7




A key challenge for surgeons is that postoperative pain management plans have traditionally been opioid based. Even single-shot nerve blocks are a challenge in this regard, because their limited duration leads to rebound pain and substantial opioid supplementation.7,11-12,16,28 This can lead to complications that delay recoveries and affect outcomes.2,11,13-15



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  13. Forastiere E, Sofra M, Giannarelli D, Fabrizi L, Simone G. Effectiveness of continuous wound infusion of 0.5% ropivacaine by ONQ pain relief system for postoperative pain management after open nephrectomy. Br J Anaesth. 2008;101(6):841847.
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  34. Ilfeld BM, Ball ST, Gearen PF, et al. Ambulatory continuous posterior lumbar plexus nerve blocks after hip arthroplasty: a dualcenter, randomized, triplemasked, placebocontrolled trial. Anesthesiology. 2008;109(3):491501.
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