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American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients.

Publication ,  Journal Article
Wu, CL; King, AB; Geiger, TM; Grant, MC; Grocott, MPW; Gupta, R; Hah, JM; Miller, TE; Shaw, AD; Gan, TJ; Thacker, JKM; Mythen, MG; McEvoy, MD ...
Published in: Anesth Analg
August 2019

Surgical care episodes place opioid-naïve patients at risk for transitioning to new persistent postoperative opioid use. With one of the central principles being the application of multimodal pain interventions to reduce the reliance on opioid-based medications, enhanced recovery pathways provide a framework that decreases perioperative opioid use. The fourth Perioperative Quality Initiative brought together a group of international experts representing anesthesiology, surgery, and nursing with the objective of providing consensus recommendations on this important topic. Fourth Perioperative Quality Initiative was a consensus-building conference designed around a modified Delphi process in which the group alternately convened for plenary discussion sessions in between small group discussions. The process included several iterative steps including a literature review of the topics, building consensus around the important questions related to the topic, and sequential steps of content building and refinement until agreement was achieved and a consensus document was produced. During the fourth Perioperative Quality Initiative conference and thereafter as a writing group, reference applicability to the topic was discussed in any area where there was disagreement. For this manuscript, the questions answered included (1) What are the potential strategies for preventing persistent postoperative opioid use? (2) Is opioid-free anesthesia and analgesia feasible and appropriate for routine operations? and (3) Is opioid-free (intraoperative) anesthesia associated with equivalent or superior outcomes compared to an opioid minimization in the perioperative period? We will discuss the relevant literature for each questions, emphasize what we do not know, and prioritize the areas for future research.

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Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

August 2019

Volume

129

Issue

2

Start / End Page

567 / 577

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Terminology as Topic
  • Risk Factors
  • Risk Assessment
  • Postoperative Care
  • Pain, Postoperative
  • Pain Management
  • Opioid-Related Disorders
  • Incidence
 

Citation

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Chicago
ICMJE
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Wu, C. L., King, A. B., Geiger, T. M., Grant, M. C., Grocott, M. P. W., Gupta, R., … Fourth Perioperative Quality Initiative Workgroup, . (2019). American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients. Anesth Analg, 129(2), 567–577. https://doi.org/10.1213/ANE.0000000000004194
Wu, Christopher L., Adam B. King, Timothy M. Geiger, Michael C. Grant, Michael P. W. Grocott, Ruchir Gupta, Jennifer M. Hah, et al. “American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients.Anesth Analg 129, no. 2 (August 2019): 567–77. https://doi.org/10.1213/ANE.0000000000004194.
Wu, Christopher L., et al. “American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients.Anesth Analg, vol. 129, no. 2, Aug. 2019, pp. 567–77. Pubmed, doi:10.1213/ANE.0000000000004194.
Wu CL, King AB, Geiger TM, Grant MC, Grocott MPW, Gupta R, Hah JM, Miller TE, Shaw AD, Gan TJ, Thacker JKM, Mythen MG, McEvoy MD, Fourth Perioperative Quality Initiative Workgroup. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients. Anesth Analg. 2019 Aug;129(2):567–577.

Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

August 2019

Volume

129

Issue

2

Start / End Page

567 / 577

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Terminology as Topic
  • Risk Factors
  • Risk Assessment
  • Postoperative Care
  • Pain, Postoperative
  • Pain Management
  • Opioid-Related Disorders
  • Incidence