An Evidence-Based Approach to the Prescription Opioid Epidemic in Orthopedic Surgery

被引:108
作者
Soffin, Ellen M. [1 ]
Waldman, Seth A. [1 ]
Stack, Roberta J. [1 ]
Liguori, Gregory A. [1 ]
机构
[1] Hosp Special Surg, Dept Anesthesiol, 535 E 70th St, New York, NY 10021 USA
关键词
ACUTE-PAIN-MANAGEMENT; POSTOPERATIVE OPIATE USE; REGIONAL ANESTHESIA; EDUCATIONAL-PROGRAM; TRANSITIONAL PAIN; AMERICAN-SOCIETY; WORSE OUTCOMES; MISUSE; OVERDOSE; IMPACT;
D O I
10.1213/ANE.0000000000002433
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level. The main components of our program include (1) guidelines for managing patients who are opioid tolerant and/or have a substance abuse disorder; (2) education programs for patients, emphasizing the role of opioids in recovery after elective orthopedic surgery; (3) education programs for prescribers of controlled substances, including clinical and regulatory aspects; (4) the development of surgery-specific prescribing recommendations for opioid-naive patients; and (5) mechanisms to modify prescribing habits to limit unnecessary prescribing of controlled substances.
引用
收藏
页码:1704 / 1713
页数:10
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