Opioid Management in the Setting of Enhanced Recovery After Surgery (ERAS) Protocols

Area of Science:

• Anesthesiology
• Obstetrics and Gynecology
• Pain Management

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are increasingly adopted in OB/GYN to optimize patient perioperative experiences.
• Multimodal pain management is a cornerstone of ERAS, often incorporating opioids.
• Nonopioid analgesics play a crucial role in ERAS pain regimens.

Purpose of the Study:

• To review the role of nonopioid analgesics in ERAS protocols within OB/GYN.
• To explore strategies for opioid-sparing analgesia in the perioperative setting.
• To guide postoperative pain management balancing efficacy and safety.

Main Methods:

• Literature review of ERAS protocols in OB/GYN.
• Analysis of multimodal pain management strategies, including nonopioid and opioid analgesics.
• Examination of opioid utilization and opioid-sparing techniques.

Main Results:

• Nonopioid analgesics (acetaminophen, NSAIDs, gabapentinoids, ketamine, etc.) are integral to ERAS multimodal pain regimens.
• Opioid-sparing analgesia is achievable in select patients.
• Postdischarge pain management should continue multimodal approaches with limited opioid prescriptions.

Conclusions:

• ERAS protocols in OB/GYN effectively utilize multimodal pain management to enhance recovery.
• Strategic use of nonopioid analgesics can reduce perioperative opioid utilization.
• Balancing effective pain control with minimizing opioid risks is essential for postoperative care.