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Rigshospitalet - en del af Københavns Universitetshospital
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Perioperative Opioid Administration: A Critical Review of Opioid-free versus Opioid-sparing Approaches

Publikation: Bidrag til tidsskriftReviewpeer review

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Vis graf over relationer

Opioids form an important component of general anesthesia and perioperative analgesia. Discharge opioid prescriptions are identified as a contributor for persistent opioid use and diversion. In parallel, there is increased enthusiasm to advocate opioid-free strategies, which include a combination of known analgesics and adjuvants, many of which are in the form of continuous infusions. This article critically reviews perioperative opioid use, especially in view of opioid-sparing versus opioid-free strategies. The data indicate that opioid-free strategies, however noble in their cause, do not fully acknowledge the limitations and gaps within the existing evidence and clinical practice considerations. Moreover, they do not allow analgesic titration based on patient needs; are unclear about optimal components and their role in different surgical settings and perioperative phases; and do not serve to decrease the risk of persistent opioid use, thereby distracting us from optimizing pain and minimizing realistic long-term harms.

OriginalsprogEngelsk
Artikelnummer003572
TidsskriftAnesthesiology
Vol/bind134
Udgave nummer4
Sider (fra-til)645-659
Antal sider15
ISSN0003-3022
DOI
StatusUdgivet - 1 apr. 2021

Bibliografisk note

Copyright © 2020, the American Society of Anesthesiologists, Inc. All Rights Reserved.

ID: 60986343