I am a
Home I AM A Search Login

Papers of the Week

Papers: 25 Jul 2020 - 31 Jul 2020

2020 Jun

Best Pract Res Clin Anaesthesiol



Chronic pain and substance abuse disorders: Preoperative assessment and optimization strategies.


Kaye AD, Kandregula S, Kosty J, Sin A, Guthikonda B, Ghali GE, Craig MK, Pham AD, Reed DS, Gennuso SA, Reynolds RM, Ehrhardt K P, Cornett EM, Urman RD
Best Pract Res Clin Anaesthesiol. 2020 Jun; 34(2):255-267.
PMID: 32711832.


There is an ever-increasing number of opioid users among chronic pain patients and safely managing them can be challenging for surgeons, anesthesiologists, pain experts, and addiction specialists. Healthcare providers must be familiar with phenomena typical of opioid users and abusers, including tolerance, physical dependence, hyperalgesia, and addiction. Insufficient pain management is very common in these patients. Patient-centered preoperative communication is integral to setting realistic expectations for postoperative pain, developing successful nonopioid analgesic regimens, minimizing opioid consumption during the postoperative period, and decreasing the number of opioid pills at the risk of diversion. Preoperative evaluation should identify comorbidities and identify risk factors for substance abuse and withdrawal. Intraoperative and postoperative strategies can ensure safe and effective pain management and minimize the potential for morbidity and mortality in this high-risk patient population.