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[Acute pain management in opioid-maintained patients]
Elena Manguzzi1, Laura Wainstein2, Jules Desmeules2
1Service de médecine interne et réhabilitation, Département de médecine interne, réhabilitation et gériatrie, HUG, 1211 Genève 14.
Revue Medicale Suisse
|June 27, 2018
Summary
Managing acute pain in patients on opioid substitution therapy (OST) requires individualized care. This involves multimodal analgesia, often continuing OST and adding non-opioid or opioid pain relief strategies tailored to the patient.
Area of Science:
- Pain Management
- Pharmacology
- Addiction Medicine
Context:
- Acute nociceptive pain management in patients undergoing opioid substitution therapy (OST) presents unique challenges.
- Patient pain sensibility and the pharmacological profile of OST necessitate tailored treatment approaches.
- Effective pain management requires careful consideration of both the patient's pain and their specific OST regimen.
Purpose:
- To summarize pharmacological strategies for treating acute pain in patients on OST.
- To highlight key considerations regarding pain characteristics and OST in this population.
- To identify and address barriers to effective pain management.
Summary:
- The standard approach involves continuing OST and implementing multimodal analgesia based on pain intensity.
- Multimodal analgesia can incorporate non-pharmacological methods, non-opioid medications, and carefully selected opioid medications.
- Treatment selection must account for the specific OST medication the patient is receiving.
Impact:
- Facilitates individualized pain management for a vulnerable patient group.
- Aims to prevent negative health consequences associated with undertreated pain.
- Emphasizes the importance of interprofessional collaboration for optimal patient outcomes.
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