An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients.
Nicholas LevyJane QuinlanKariem El-BoghdadlyW J FawcettVandana AgarwalR B BastableFelicia J CoxHans Donald de BoerS C DowdyK HattinghRoger David KnaggsEdward R MarianoP PelosiMichael J ScottDileep N LoboPamela E MacintyrePublished in: Anaesthesia (2020)
This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri-operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postoperative opioid-related harm, including persistent postoperative opioid use; opioid-induced ventilatory impairment; non-medical opioid use; opioid diversion and dependence; and driving under the influence of prescription opioids. Recommended strategies to reduce harm include pre-operative assessment of the risk of persistent postoperative opioid use; use of an assessment of patient function rather than unidimensional pain scores alone to guide adequacy of analgesia; avoidance of long-acting (modified-release and transdermal patches) opioid formulations and combination analgesics; limiting the number of tablets prescribed at discharge; providing deprescribing advice; avoidance of automatic prescription refills; safe disposal of unused medicines; reducing the risk of opioid diversion; and better education of healthcare professionals, patients and carers. This consensus statement provides a framework for better prescribing practices that could help reduce the risk of postoperative opioid-related harm in adults.
Keyphrases
- pain management
- chronic pain
- patients undergoing
- healthcare
- primary care
- end stage renal disease
- ejection fraction
- systematic review
- chronic kidney disease
- deep learning
- spinal cord injury
- machine learning
- newly diagnosed
- prognostic factors
- risk assessment
- peritoneal dialysis
- spinal cord
- robot assisted
- minimally invasive
- anaerobic digestion
- adverse drug
- sewage sludge