Approach to pain management in chronic opioid users undergoing orthopaedic surgery

Clinton J. Devin; Dennis S. Lee; Sheyan J. Armaghani; Jesse Bible; David N. Shau; Peter R. Martin; Jesse M. Ehrenfeld

doi:10.5435/JAAOS-22-10-614

Approach to pain management in chronic opioid users undergoing orthopaedic surgery

Clinton J. Devin, Dennis S. Lee, Sheyan J. Armaghani, Jesse Bible, David N. Shau, Peter R. Martin, Jesse M. Ehrenfeld

Research output: Contribution to journal › Article › peer-review

40 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	614-622
Number of pages	9
Journal	Journal of the American Academy of Orthopaedic Surgeons
Volume	22
Issue number	10
DOIs	https://doi.org/10.5435/JAAOS-22-10-614
State	Published - Oct 1 2014

All Science Journal Classification (ASJC) codes

Surgery
Orthopedics and Sports Medicine

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abstract = "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.",

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Approach to pain management in chronic opioid users undergoing orthopaedic surgery

Abstract

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