Opioid Adjuncts: Optimizing Opioid Therapy With Nonopioid Medications

Abstract

In this article, we describe a variety of medications that physicians managing outpatient chronic pain should familiarize themselves with to better aid their approach to multimodal pain therapy. Physicians should always consider the use of an adjuvant or coanalgesic drug as first-line treatments. Although many of these medications are not primarily analgesics, in clinical practice they have independent analgesic effects or synergistic analgesic properties when used with opioids. The use of adjunct analgesics reduces opioid-related adverse effects and optimizes pain management. Although there may be some medication overlap with this section and the ERAS section, the purpose of this article is to understand prolonged use in the outpatient setting to reduce opioid use or limit opioid dose with adjuvant therapy.

Does adding muscle relaxant make post-operative pain better? a narrative review of the literature from US and European studies

“…As CASMRs have been used effectively in non-surgical patients with pain of musculoskeletal origin [ 19 ], there is anecdotal evidence of their migration to surgical pain. Our literature search revealed 12 randomized, blinded, prospective studies across a variety of surgical specialties in which CASMRs were tested for surgical pain ( Table 3 ).…”