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Opioid alternatives in spine surgeries.
Shobana Rajan1, Gaiha Rishi2, Marco Ibrahim1
1Cleveland Clinic Multispeciality Anesthesia, Cleveland, Ohio.
Current Opinion in Anaesthesiology
|August 15, 2024
Summary
Multimodal analgesia, including NSAIDs and regional blocks, offers effective opioid-sparing pain management after spine surgery. These strategies reduce opioid use and side effects, improving patient outcomes.
Area of Science:
- Anesthesiology
- Pain Management
- Neurosurgery
Background:
- The opioid crisis necessitates alternatives for perioperative pain control in spine surgery.
- Effective pain management is crucial for patient recovery and reducing opioid dependence.
Purpose of the Study:
- To review recent research on opioid alternatives for perioperative pain management in spine surgery.
- To assess the efficacy, side effects, and outcomes of these opioid-sparing strategies.
Main Methods:
- Systematic literature search for studies published within the last 18 months.
- Focus on opioid-sparing techniques and multimodal analgesia.
Main Results:
- Multimodal analgesia, including NSAIDs, acetaminophen, lidocaine, gabapentinoids, NMDA antagonists, dexmedetomidine, and regional blocks (e.g., erector spinae block, TLIF block), significantly reduces opioid consumption.
- These alternatives maintain adequate pain relief and decrease opioid-related side effects like nausea, vomiting, and extended hospital stays.
Conclusions:
- Multimodal analgesia aligns with guidelines and public health goals regarding opioid misuse.
- Balancing benefits and risks of opioid alternatives is essential; further research on long-term outcomes and diverse populations is needed.
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