Perioperative management of chronic pain patients with opioid dependency

Silviu Brill, Yehuda Ginosar, Elyad M. Davidson

Research output: Contribution to journalReview articlepeer-review

36 Scopus citations


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.

Original languageEnglish
Pages (from-to)325-331
Number of pages7
JournalCurrent Opinion in Anaesthesiology
Issue number3
StatePublished - Jun 1 2006
Externally publishedYes


  • Anesthesia
  • Chronic opioid treatment
  • Chronic pain
  • Opioid dependency
  • Perioperative management


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