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

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

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.

0003-2999
567-577
Wu, Christopher L.
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King, Adam B.
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Geiger, Timothy M.
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Grant, Michael C.
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Grocott, Michael P.W.
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Gupta, Ruchir
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Hah, Jennifer M.
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Miller, Timothy E.
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Shaw, Andrew D.
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Gan, Tong J.
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Thacker, Julie K.M.
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Mythen, Michael G.
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McEvoy, Matthew D.
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Argoff, Charles
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Edwards, David A.
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Gordon, Debra B.
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Gulur, Padma
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Hedrick, Traci L.
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Holubar, Stefan D.
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Hurley, Robert W.
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Jayaram, Jennifer
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Kent, Michael L.
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Oderda, Gary M.
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Sun, Erin
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Fourth Perioperative Quality Initiative Workgroup
Wu, Christopher L.
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King, Adam B.
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Geiger, Timothy M.
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Grant, Michael C.
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Grocott, Michael P.W.
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Gupta, Ruchir
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Hah, Jennifer M.
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Miller, Timothy E.
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Shaw, Andrew D.
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Gan, Tong J.
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Thacker, Julie K.M.
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Mythen, Michael G.
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McEvoy, Matthew D.
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Argoff, Charles
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Edwards, David A.
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Gordon, Debra B.
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Gulur, Padma
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Hedrick, Traci L.
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Holubar, Stefan D.
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Hurley, Robert W.
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Jayaram, Jennifer
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Kent, Michael L.
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Oderda, Gary M.
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Sun, Erin
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King, Adam B., Geiger, Timothy M., Grant, Michael C., Grocott, Michael P.W., Gupta, Ruchir, Hah, Jennifer M., Miller, Timothy E., Shaw, Andrew D., Gan, Tong J., Thacker, Julie K.M., Mythen, Michael G., McEvoy, Matthew D., Argoff, Charles, Edwards, David A., Gordon, Debra B., Gulur, Padma, Hedrick, Traci L., Holubar, Stefan D., Hurley, Robert W., Jayaram, Jennifer, Kent, Michael L., Oderda, Gary M. and Sun, Erin , 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. Anesthesia and Analgesia, 129 (2), 567-577. (doi:10.1213/ANE.0000000000004194).

Record type: Article

Abstract

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.

Full text not available from this repository.

More information

Accepted/In Press date: 11 March 2019
Published date: 1 August 2019

Identifiers

Local EPrints ID: 433208
URI: http://eprints.soton.ac.uk/id/eprint/433208
ISSN: 0003-2999
PURE UUID: ad619799-5100-4cd8-a29c-1860f676b45b
ORCID for Michael P.W. Grocott: ORCID iD orcid.org/0000-0002-9484-7581

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Date deposited: 12 Aug 2019 16:30
Last modified: 18 Feb 2021 17:12

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Contributors

Author: Christopher L. Wu
Author: Adam B. King
Author: Timothy M. Geiger
Author: Michael C. Grant
Author: Ruchir Gupta
Author: Jennifer M. Hah
Author: Timothy E. Miller
Author: Andrew D. Shaw
Author: Tong J. Gan
Author: Julie K.M. Thacker
Author: Michael G. Mythen
Author: Matthew D. McEvoy
Author: Charles Argoff
Author: David A. Edwards
Author: Debra B. Gordon
Author: Padma Gulur
Author: Traci L. Hedrick
Author: Stefan D. Holubar
Author: Robert W. Hurley
Author: Jennifer Jayaram
Author: Michael L. Kent
Author: Gary M. Oderda
Author: Erin Sun
Corporate Author: Fourth Perioperative Quality Initiative Workgroup

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