Perioperative Pain Management and Opioid Stewardship: A Practical Guide.

Area of Science:

• Anesthesiology
• Surgical Quality Improvement
• Pain Management

Background:

• Surgical procedures significantly contribute to pain and opioid utilization worldwide.
• Despite existing guidelines, integrating recommendations into practice remains challenging, leading to persistent postoperative pain and societal burdens.
• Complexities in perioperative care transitions and diverse healthcare provider involvement hinder process improvement.

Purpose of the Study:

• To summarize and integrate key recommendations for institutional adoption of perioperative analgesic and opioid optimization strategies.
• To provide a "roadmap" for improving pain management and reducing opioid exposure in surgical settings.
• To highlight the importance of prioritizing analgesia and opioid stewardship in surgical quality improvement.

Main Methods:

• Review of applicable statistics and definitions related to postoperative pain and opioid use.
• Examination of recommended analgesic and anesthetic modalities across all phases of perioperative care.
• Emphasis on interprofessional collaboration and patient perspectives in implementing performance measures.

Main Results:

• Challenges to process improvement include numerous guidelines, multiple healthcare providers, evolving surgical techniques, and complex care transitions.
• A collaborative, integrated approach is essential for optimizing pain management and opioid stewardship.
• Implementation of perioperative performance measures requires interprofessional teamwork.

Conclusions:

• Surgery centers globally must adopt an integrated, collaborative approach to achieve optimal pain management and opioid stewardship.
• Addressing persistent postoperative pain and opioid use requires a comprehensive strategy across the care continuum.
• Prioritizing both effective analgesia and responsible opioid prescribing is vital for surgical quality improvement.