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Perioperative Opioid Administration
- Source :
- Anesthesiology. 134:645-659
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Opioids form an important component of general anesthesia and perioperative analgesia. Discharge opioid prescriptions are identified as a contributor for persistent opioid use and diversion. In parallel, there is increased enthusiasm to advocate opioid-free strategies, which include a combination of known analgesics and adjuvants, many of which are in the form of continuous infusions. This article critically reviews perioperative opioid use, especially in view of opioid-sparing versus opioid-free strategies. The data indicate that opioid-free strategies, however noble in their cause, do not fully acknowledge the limitations and gaps within the existing evidence and clinical practice considerations. Moreover, they do not allow analgesic titration based on patient needs; are unclear about optimal components and their role in different surgical settings and perioperative phases; and do not serve to decrease the risk of persistent opioid use, thereby distracting us from optimizing pain and minimizing realistic long-term harms.
- Subjects :
- Pain, Postoperative
medicine.medical_specialty
business.industry
Opioid use
Analgesic
Perioperative
Opioid-Related Disorders
Perioperative Care
Analgesics, Opioid
Clinical Practice
03 medical and health sciences
0302 clinical medicine
Anesthesiology and Pain Medicine
Opioid
030202 anesthesiology
Perioperative analgesia
Humans
Medicine
Medical prescription
business
Intensive care medicine
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 15281175 and 00033022
- Volume :
- 134
- Database :
- OpenAIRE
- Journal :
- Anesthesiology
- Accession number :
- edsair.doi.dedup.....3ae75c9f1ececfe492edd2e57e9651ef