Perioperative Opioid Management Strategies: Do They Make a Difference in Long-Term Health Outcomes?

Purpose of ReviewWith the ongoing opioid epidemic, efforts have been made to limit opioid overprescribing and prevent misuse. This review looks at long-term outcomes of opioid management strategies.Recent FindingsApproaches to opioid management in the perioperative phase include implementation of opioid stewardship programs, use of regional anesthesia techniques, addition of non-opioid analgesics, and adoption of enhanced recovery protocols. While the effects of these strategies on short-term outcomes have been extensively studied and reported, less is known about long-term health outcomes. To date, few studies have even collected data on potential long-term outcomes, and results are mixed regarding benefit with some studies showing equivocal outcomes.SummaryWhile long-term health benefits have not been proven conclusively, there is sufficient evidence of short-term benefit to justify various opioid management strategies for surgical patients. The chronification of acute pain and opioid use after surgery typically occur during the subacute period after surgery, when patients are typically at home. A transitional pain service may help bridge the multiple services involved in perioperative pain management and provide the necessary surveillance and timely intervention that at-risk patients may need to prevent chronic pain and long-term opioid use.