The Opioid Crisis and the Orthopedic Surgeon.
J Arthroplasty
; 33(11): 3379-3382.e1, 2018 11.
Article
en En
| MEDLINE
| ID: mdl-30075877
ABSTRACT
Opioid use and abuse has become a national crisis in the United States. Many opioid abusers become addicted through an initial course of legal, physician-prescribed medications. Consequently, there has been increased pressure on medical care providers to be better stewards of these medications. In orthopedic surgery and total joint arthroplasty, pain control after surgery is critical for restoring mobility and maintaining patient satisfaction in the early postoperative period. Before the opioid misuse epidemic, orthopedic surgeons were frequently influenced to "treat pain with pain medications." Long-acting opioids, such as OxyContin were used commonly. In the past decade, there has been a paradigm shift in favor of multimodal pain control with limited opioid use. This review will discuss 4 major topics. First, we will describe the pressures on orthopedic surgeons to prescribe narcotic pain medications. We will then discuss the major and minor complications and side effects associated with these prescriptions. Second, we will review how these factors motivated the development of alternative pain management strategies and a multimodal approach. Third, we will look at perioperative interventions that can reduce postoperative opioid consumption, including wound injections and peripheral nerve blocks, which have shown superb clinical results. Finally, we will recommend an evidence-based program that avoids parenteral narcotics and facilitates rapid discharge home without readmissions for pain-related complaints.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Manejo del Dolor
/
Cirujanos Ortopédicos
/
Analgésicos Opioides
/
Trastornos Relacionados con Opioides
Tipo de estudio:
Etiology_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Año:
2018
Tipo del documento:
Article