The challenge of perioperative pain management in opioid-tolerant patients
| Autor: | Claudio Leonardi, Patrizia Romualdi, Mario Dauri, Flaminia Coluzzi, Arturo Cuomo, Francesca Bifulco, Silvia Natoli, Rita Maria Melotti, G Savoia, Antonio Corcione |
|---|---|
| Přispěvatelé: | Coluzzi, Flaminia, Bifulco, Francesca, Cuomo, Arturo, Dauri, Mario, Leonardi, Claudio, Melotti, Rita Maria, Natoli, Silvia, Romualdi, Patrizia, Savoia, Gennaro, Corcione, Antonio |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
media_common.quotation_subject Population Settore MED/41 - Anestesiologia RM1-950 Review anesthesia abuser Naltrexone methadone 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology medicine Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics Intensive care medicine education media_common education.field_of_study Chemical Health and Safety business.industry Addiction Chronic pain opioids opioid tolerant General Medicine Perioperative medicine.disease buprenorphine abuse abusers Opioid opioid addiction postoperative pain Therapeutics. Pharmacology business Safety Research 030217 neurology & neurosurgery Buprenorphine medicine.drug Methadone |
| Zdroj: | Therapeutics and Clinical Risk Management Therapeutics and Clinical Risk Management, Vol Volume 13, Pp 1163-1173 (2017) |
| ISSN: | 1178-203X 1176-6336 |
| Popis: | Flaminia Coluzzi,1 Francesca Bifulco,2 Arturo Cuomo,2 Mario Dauri,3 Claudio Leonardi,4 Rita Maria Melotti,5 Silvia Natoli,3 Patrizia Romualdi,6 Gennaro Savoia,7 Antonio Corcione8 1Department of Medical and Surgical Sciences and Biotechnologies, Unit of Anaesthesia, Intensive Care and Pain Medicine, Sapienza University of Rome, Polo Pontino, Latina, 2National Cancer Institute “G Pascale” Foundation, Unit of Anaesthesia, Intensive Care and Pain Medicine, Naples, 3Department of Clinical Science and Translational Medicine, Tor Vergata University of Rome, 4Addiction Disease Department, Local Health Unit (ASL) Rome 2, Rome, 5Department of Medical and Surgical Sciences, 6Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, Bologna, 7Department Anesthesia, Fatebenefratelli Hospital, Naples, 8Unit of Anaesthesia and Intensive Care, Dei Colli Hospital, V. Monaldi, Naples, Italy Abstract: The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal. Clinicians are encouraged to plan perioperative pain medications and to refer these patients to psychiatrists and addiction specialists for their evaluation. The aim of this review was to give practical suggestions for perioperative management of surgical opioid-tolerant patients, together with schemes of opioid conversion for chronic pain patients assuming oral or transdermal opioids, and patients under maintenance programs with methadone, buprenorphine, or naltrexone. Keywords: opioids, postoperative pain, addiction, abusers, buprenorphine, methadone |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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