Updates From the Other Side of the Drape: Recent Advances in Multimodal Pain Management and Opioid Reduction Among

Andrew D Franklin1, KuoJen Tsao2, Rabab Barq3

  • 1Division of Pediatric Anesthesia, Department of Anesthesia, Vanderbilt University Medical Center, Nashville, TN, USA.

PubMed

Insights

Multimodal pain management and enhanced recovery pathways improve surgical outcomes for children. This approach reduces opioid exposure and enhances patient satisfaction through multidisciplinary care.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Anesthesiology

Background:

  • Evolving strategies for pediatric acute pain management.
  • Increased awareness of opioid risks (short and long-term).
  • Need for improved perioperative outcomes and patient satisfaction.

Purpose of the Study:

  • Discuss current enhanced recovery after surgery (ERAS) pathways.
  • Explore alternative pain control methods.
  • Highlight education and advocacy for opioid reduction.

Main Methods:

  • Multidisciplinary discussion at a 2023 symposium.
  • Focus on organized pathways for perioperative care.
  • Review of enhanced recovery after surgery (ERAS) protocols.

Main Results:

  • Multimodal and multidisciplinary approaches improve outcomes.
  • Organized pathways lead to better patient satisfaction.
  • Discussion emphasized opioid reduction strategies.

Conclusions:

  • Enhanced recovery after surgery pathways are key to optimizing pediatric surgical care.
  • Multimodal strategies effectively manage acute pain while minimizing opioid risks.
  • Continued focus on education and advocacy is crucial for opioid reduction.

Related Concept Videos

Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
287
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
614
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
243
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
119
Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
86