Perioperative Pain Management in Patients on Opioid Replacement Therapy: An Integrative Review
Meghan Boer, DNAP, CRNA
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Despite the lack of compelling evidence to support long-term efficacy in the treatment of opioid abuse, opioids are one of the most common classes of medications prescribed in the United States. As such, the significant increase in prescription and illicit opioid abuse since the nineties has led to a surge in patients recovering from addiction and now maintained on opioid replacement therapy (ORT). Due to this rapid growth in ORT, there has been a strong interest in utilization of opioid agonists such as methadone, and partial agonists such as buprenorphine, which have been increasingly utilized to treat severe chronic pain and to prevent withdrawal symptoms in those who have an addiction to opiates. The growth of this patient population has presented anesthesia providers with a challenge. Specifically, these medications interfere with the usual effect of opioids anesthesia providers use to deliver anesthesia and treat acute pain. Understanding the pharmacodynamics of the individual ORT medications prescribed is critical in terms of using the best practices to control pain in the perioperative setting. Additionally, it is imperative to communicate with all members of the healthcare team and to have a plan for managing acute perioperative pain.
|Type||Other Graduate Paper|
|Review Type||Faculty Approved: Degree-based Submission|
|Keywords||Opioid Use Disorder;
Opioid Replacement Therapy;
|CINAHL Subject(s)||Perioperative Care;
Substance Use Disorders;
Substance Use Disorders--Therapy;
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