Opioid Use After Upper Extremity Surgery

被引:37
|
作者
Gauger, Erich M. [1 ]
Gauger, Erica J. [2 ]
Desai, Mihir J. [1 ]
Lee, Donald H. [1 ]
机构
[1] Vanderbilt Univ, Med Ctr, Vanderbilt Dept Orthopaed, 1215 21st Ave South,Ste 3200, Nashville, TN 37232 USA
[2] TRIA Orthopaed Ctr, Woodbury, MN USA
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 2018年 / 43卷 / 05期
关键词
Opioid; opioid abuse; narcotics; upper extremity; HAND SURGERY; POSTOPERATIVE PAIN; MANAGEMENT; BLOCKADE; SAFETY;
D O I
10.1016/j.jhsa.2018.02.026
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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. Copyright (C) 2018 by the American Society for Surgery of the Hand. All rights reserved.
引用
收藏
页码:470 / 479
页数:10
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