Fast Five Quiz: Overview of Acute Pain Management

Shaheen E. Lakhan, MD, PhD, MS, MEd


January 14, 2022

Identifying opioid use before surgery is an important opportunity to optimize postoperative care. A recent study found that patients with nonchronic, periodic opioid use before surgery were vulnerable to persistent postoperative opioid use. In the study, 41% of 191,043 patients undergoing an elective surgical procedure had filled an opioid prescription in the preceding year, and those patients were 2 to 12 times more likely to continue to fill opioids for an extended period after surgery compared with opioid-naive patients. Patients with low-dose, recent, moderate opioid use were the most at risk — more than 1 out of every 2 of these patients developed persistent use after surgery. These patients were also nearly three times more likely to develop persistent use than were remote intermittent users.

A Cochrane meta-analysis found that although there was some evidence that preemptive and preventive NSAIDs reduce both pain and morphine consumption in the postoperative setting, this was not universal for all pain and morphine consumption outcomes. Moreover, any differences found were not clinically significant, nor was there any evidence of reductions in opioid adverse effects, although few studies reported these outcomes. 

Learn more about patient factors and postoperative opioid consumption.


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