TY - JOUR
T1 - Perioperative management of chronic pain patients with opioid dependency
AU - Brill, Silviu
AU - Ginosar, Yehuda
AU - Davidson, Elyad M.
PY - 2006/6/1
Y1 - 2006/6/1
N2 - PURPOSE OF REVIEW: In this article, we discuss the perioperative anesthesia and pain management of patients with chronic pain receiving chronic opioid administration. In our practice we may expect to be confronted with opioid-dependent patients in routine anesthesia practice and should acquire specific knowledge and skills to effectively manage the perioperative and acute pain management issues that arise. RECENT FINDINGS: The number of patients treated chronically with opioids has increased steadily over the past decade; currently about 10% of all chronic-pain patients are treated with opioids. As these patients are no longer confined to terminally ill cancer patients, growing numbers of these patients are facing surgical interventions. SUMMARY: In our clinical practice, we should employ multimodal pain management therapy by using an around-the-clock regimen of nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, acetaminophen, and regional blockade. Dosing regimens should be individualized to optimize efficacy while minimizing the risk of adverse events.
AB - PURPOSE OF REVIEW: In this article, we discuss the perioperative anesthesia and pain management of patients with chronic pain receiving chronic opioid administration. In our practice we may expect to be confronted with opioid-dependent patients in routine anesthesia practice and should acquire specific knowledge and skills to effectively manage the perioperative and acute pain management issues that arise. RECENT FINDINGS: The number of patients treated chronically with opioids has increased steadily over the past decade; currently about 10% of all chronic-pain patients are treated with opioids. As these patients are no longer confined to terminally ill cancer patients, growing numbers of these patients are facing surgical interventions. SUMMARY: In our clinical practice, we should employ multimodal pain management therapy by using an around-the-clock regimen of nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, acetaminophen, and regional blockade. Dosing regimens should be individualized to optimize efficacy while minimizing the risk of adverse events.
KW - Anesthesia
KW - Chronic opioid treatment
KW - Chronic pain
KW - Opioid dependency
KW - Perioperative management
UR - http://www.scopus.com/inward/record.url?scp=33744983908&partnerID=8YFLogxK
U2 - 10.1097/01.aco.0000192813.38236.99
DO - 10.1097/01.aco.0000192813.38236.99
M3 - Review article
C2 - 16735818
AN - SCOPUS:33744983908
SN - 0952-7907
VL - 19
SP - 325
EP - 331
JO - Current Opinion in Anaesthesiology
JF - Current Opinion in Anaesthesiology
IS - 3
ER -