The patient with substance use disorder

Area of Science:

• Anesthesiology
• Psychiatry
• Pharmacology

Background:

• Substance use disorder (SUD) criteria have been updated with the DSM-5.
• Opioid use disorder (OUD) is a significant public health concern impacting surgical populations.

Purpose of the Study:

• To outline the perioperative challenges anesthesiologists encounter when managing patients with substance use disorder, with a focus on opioid use disorder.
• To highlight the importance of tailored anesthetic and analgesic strategies for patients with OUD.

Main Methods:

• This review synthesizes current literature on the perioperative management of patients with SUD and OUD.
• Key considerations include pre-anesthetic evaluation, intraoperative anesthetic choices, and postoperative pain management.

Main Results:

• Patients with OUD require specialized care, including multimodal analgesia for effective postoperative pain management.
• Maintenance therapy and withdrawal status significantly influence anesthetic management decisions.

Conclusions:

• Patients with SUD, particularly OUD, represent a distinct surgical population requiring careful perioperative management.
• Anesthesiologists must be prepared to address the complexities of SUD/OUD to optimize patient outcomes and long-term recovery.