期刊
SPORTS MEDICINE AND ARTHROSCOPY REVIEW
卷 27, 期 3, 页码 112-118出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JSA.0000000000000244
关键词
opioid epidemic; multimodal analgesia; opioid-sparing anesthesia; regional anesthesia; nonopioid analgesics; hyperalgesia
The opioid epidemic continues to be a problem in the United States and prescription opioid overdose fatalities continue to rise. Chronic opioid use threatens military readiness and puts service members at risk for medical separation from military service. Orthopedic surgeons commonly prescribe opioid medications for postsurgical patients. Long-term opioid use can be the result of acute, postoperative opioid intake. Overprescribing may increase the risk of long-term opioid use, medication diversion and adverse outcomes. Preoperative administration of opioids dramatically increases the risk of continued use up to 1 year after surgery. Strategies to minimize opioid use include opioid-specific preoperative counseling, multimodal analgesia with opioid-sparing oral and intravenous medications, regional anesthesia, minimizing tourniquet use, and preoperative behavioral health evaluation.
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