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Team Approach: Multimodal Perioperative Pain Management in Upper-Extremity Surgery

Combating the Opioid Epidemic

Stewart, Thomas M., MD1; Pulos, Nicholas, MD1; Curry, Timothy B., MD, PhD1; Gazelka, Halena M., MD1; Brown, Michael J., MD1; Shin, Alexander Y., MD1,a

doi: 10.2106/JBJS.RVW.17.00190
Review Article-Team Approach

  • * Rates of opioid use and abuse continue to rise in the United States, as do opioid-related deaths. Many patients who misuse opioids receive their first exposure in the perioperative setting.
  • * Postoperative opioid use reduction in patients who have undergone an upper-extremity procedure can be difficult secondary to the often-painful nature of orthopaedic procedures. Postoperative pain can prevent timely discharge from hospitals and is a major cause for emergency medicine visits following outpatient upper-extremity surgical procedures.
  • * Utilization of a multidisciplinary, multimodal, home-going continuous peripheral nerve block catheter protocol may be able to comfortably allow patients to recover in an outpatient setting after an upper-extremity surgical procedure, with a diminished opioid requirement.

1Department of Anesthesiology and Perioperative Medicine (T.M.S., T.B.C., and M.J.B.), Division of Pain Medicine (H.M.G.), and Department of Orthopedic Surgery (N.P. and A.Y.S.), Mayo Clinic, Rochester, Minnesota

aE-mail address for A.Y. Shin:

Copyright © 2018 by The Journal of Bone and Joint Surgery, Incorporated
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