Opioid Use After Upper Extremity Surgery
| Autor: | Erich M. Gauger, Mihir J. Desai, Erica J. Gauger, Donald H. Lee |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Biomedical Research Population 030230 surgery Drug Prescriptions Upper Extremity 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Orthopedics and Sports Medicine Practice Patterns Physicians' Intensive care medicine education Prescription Drug Misuse 030222 orthopedics education.field_of_study Pain Postoperative business.industry Opioid use Upper extremity surgery Nerve Block Perioperative medicine.disease Opioid-Related Disorders United States Review article Substance abuse Analgesics Opioid Opioid Prescription opioid Surgery business medicine.drug |
| Zdroj: | The Journal of hand surgery. 43(5) |
| ISSN: | 1531-6564 |
| Popis: | Ever since the institution of pain as the fifth vital sign, there has been a rising opioid epidemic in the United States, with Americans now consuming 80% of the global opioid supply while representing only 5% of the world's population. Surgeons are tasked with the duty of both managing patients' pain in the perioperative period and following responsible prescribing behaviors. Several articles have been published with the goal of evaluating opioid use after upper extremity surgery, risk factors for opioid misuse/abuse, the impact of anesthetic type, and the role of multimodal pain management regimens. These studies have found that, on average, surgeons prescribe 2 to 5 times more opioids than patients consume. Multimodal pain management strategies are effective for decreasing postoperative opioid consumption. Risk factors for prolonged opioid use and/or misuse are younger age, history of substance abuse, psychological disorders, and previous pain diagnoses. Use of regional blockade anesthesia, particularly with long-acting agents or indwelling catheters, can be helpful in the management of postoperative pain. This review article summarizes the available literature regarding opioid use after upper extremity surgery to provide the surgeon with additional information to make informed decisions regarding postoperative opioid prescription. |
| Databáze: | OpenAIRE |
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