Improving Postoperative Pain Management in Orthopedic Total Joint Surgical Patients With Opioid Tolerance Using the Iowa Model Of Evidence-Based Practice

Doi, Kathleen; Gibbons, Gregory; Shimoda, Rosanne

doi:10.1016/j.jopan.2014.08.124

Cited by 2 publications

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“…We found that orthopedic surgeons are advised to familiarize themselves with multimodal pain control methods, including peripheral nerve blocks, non-opioid pharmacotherapy, and lifestyle modifications [22, 31]. Collaboration among surgeons, anesthesiologists, nurses, and all other healthcare staff involved in the care of a patient after orthopedic surgery is a well-substantiated measure in reducing risk of post-operative dependence or addiction [10]. The bioethical principle of non-maleficence holds surgeons accountable for the damage done through the overprescription of opioids.…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary Mitigation of Opioid Misuse in Musculoskeletal Patients

Saigal

Jones

2019

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: The opioid prescribing patterns of orthopedic surgeons have been shown to play a role in exacerbating rates of opioid misuse among postsurgical patients. Demonstrable success has been appreciated by combining policy-level approaches and clinical education-based strategies to inform patients of alternative modalities of post-operative analgesia. Questions/ Purposes: The purpose of this review was to address two questions: What are the most substantiated measures orthopedic surgeons can take to limit opioid misuse or addiction among their patients? What advantages are gained in orthopedic surgeons' collaborating with other healthcare professionals with influence over patients' post-operative opioid exposure? Methods: We searched two databases for articles on multidisciplinary policybased solutions to mitigating the opioid overdose crisis among musculoskeletal patients. Articles produced from the search were searched for further evidence supporting the use of standardized clinical and administrative protocols in mitigating opioid misuse within this patient population. Successful approaches to mitigating misuse of opioids in this demographic were synthesized from recurring themes in the studies. Results: Multiple articles support orthopedic surgeons being aware of the risk factors for chronic opioid use among their patients, as well as multidisciplinary strategies involving orthopedic surgeons and other healthcare/governmental professionals to address the burden of the opioid crisis on surgical patients. Conclusions: Addressing the misuse of opioids among orthopedic patients requires appropriate prescribing practices and long-term support of patients. Collaboration between surgeons and policymaking entities is recognized as an effective population-wide approach to preventing opioid dependence, misuse, and addiction. Keywords interdisciplinary. multilateral. opioid overdose crisis. post-operative pain management. orthopedic surgery. musculoskeletal patients. medico-legal collaboration. health policy. bioethics. anesthesia. nursing

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Section: Discussionmentioning

confidence: 99%

Interdisciplinary Mitigation of Opioid Misuse in Musculoskeletal Patients

Saigal

Jones

2019

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…Opioid tolerance is defined by Yaksh and Wallace as the reduction of analgesic efficacy of a particular dose of an opioid as that dose is repeatedly given over time [ 19 ]. Opioid tolerance occurs in as little as 2 weeks [ 67 ]. Tolerance is observable at the level of reduced analgesic and sedative effects.…”

Section: Introductionmentioning

confidence: 99%

The opioid epidemic: a central role for the blood brain barrier in opioid analgesia and abuse

Schaefer¹,

Tome²,

Davis³

2017

Fluids Barriers CNS

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Opioids are currently the primary treatment method used to manage both acute and chronic pain. In the past two to three decades, there has been a surge in the use, abuse and misuse of opioids. The mechanism by which opioids relieve pain and induce euphoria is dependent on the drug crossing the blood–brain barrier and accessing the central nervous system. This suggests the blood brain barrier plays a central role in both the benefits and risks of opioid use. The complex physiological responses to opioids that provide the benefits and drive the abuse also needs to be considered in the resolution of the opioid epidemic.

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Improving Postoperative Pain Management in Orthopedic Total Joint Surgical Patients With Opioid Tolerance Using the Iowa Model Of Evidence-Based Practice

Cited by 2 publications

References 0 publications

Interdisciplinary Mitigation of Opioid Misuse in Musculoskeletal Patients

Interdisciplinary Mitigation of Opioid Misuse in Musculoskeletal Patients

The opioid epidemic: a central role for the blood brain barrier in opioid analgesia and abuse

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