Review of perioperative pain management of opioid-dependent patients

Nalini Vadivelu, MD; Sukanya Mitra, MD, MAMS; Alice M. Kai, BA; Gopal Kodumudi, MS; Karina Gritsenko, MD

doi:10.5055/jom.2016.0344

Authors

Nalini Vadivelu, MD
Sukanya Mitra, MD, MAMS
Alice M. Kai, BA
Gopal Kodumudi, MS
Karina Gritsenko, MD

DOI:

https://doi.org/10.5055/jom.2016.0344

Keywords:

chronic pain, opioid dependence, prescription opioids, multimodal analgesia, opioid abuse

Abstract

Opioid dependence can occur due to prescription opioid use, recreational opioid use, or as a result of opioid use for the treatment of drug addiction. Pain control in these patients is truly a challenge. It is important to understand the patient's condition such as the phenomenon of drug dependence, drug addiction, and pseudo-addiction to provide effective analgesia. This may be accomplished using appropriate multimodal therapies and by treatment of coexisting diseases such as anxiety. The goal is to provide effective analgesia, prevent cognitive and emotional problems, and produce a positive postoperative rehabilitation process. Multimodal options include pharmacological and nonpharmacological approaches, psychological support, and interventional pain procedures, all focused toward providing optimal pain control while preventing undertreatment, withdrawal symptoms, and other complications.

Author Biographies

Nalini Vadivelu, MD

Associate Professor of Anesthesiology, Department of Anesthesiology, Yale University, New Haven, Connecticut.

Sukanya Mitra, MD, MAMS

Professor of Anaesthesiology, Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India

Alice M. Kai, BA

Medical Student, Stony Brook School of Medicine, Stony Brook, New York

Gopal Kodumudi, MS

Medical Student, California North State University College of Medicine, Elk Grove, California

Karina Gritsenko, MD

Assistant Professor of Anesthesiology, Department of Anesthesiology, Pain Medicine, Regional Anesthesiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York

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