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Perioperative Pain Management and Avoidance of Long-term Opioid Use

Patzkowski, Michael S. MD*; Patzkowski, Jeanne C. MD

Sports Medicine and Arthroscopy Review: September 2019 - Volume 27 - Issue 3 - p 112–118
doi: 10.1097/JSA.0000000000000244
Review Articles

The opioid epidemic continues to be a problem in the United States and prescription opioid overdose fatalities continue to rise. Chronic opioid use threatens military readiness and puts service members at risk for medical separation from military service. Orthopedic surgeons commonly prescribe opioid medications for postsurgical patients. Long-term opioid use can be the result of acute, postoperative opioid intake. Overprescribing may increase the risk of long-term opioid use, medication diversion and adverse outcomes. Preoperative administration of opioids dramatically increases the risk of continued use up to 1 year after surgery. Strategies to minimize opioid use include opioid-specific preoperative counseling, multimodal analgesia with opioid-sparing oral and intravenous medications, regional anesthesia, minimizing tourniquet use, and preoperative behavioral health evaluation.

Departments of *Anesthesia

Orthopaedic Surgery, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, TX

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of San Antonio Military Medical Center, the Department of the Army, or the Department of Defense.

Disclosure: The authors declare no conflict of interest.

Reprints: Jeanne C. Patzkowski, MD, Department of Orthopaedic Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, San Antonio, TX 78234.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.