Postoperative care of the chronic opioid-consuming patient.
Recently, there has been a significant increase in the use of opioid analgesics for chronic pain in the outpatient setting. As a result, anesthesiologists are commonly presented with the dilemma of treating acute postoperative pain in patients who do not receive adequate analgesia with conventional doses of opioid. This article presents a practical approach to treating postoperative pain in the chronic opioid-consuming patient. Specifically, a technique based on pharmacokinetic modeling is described that predicts safe and therapeutic opioid dosing in these patients.
Swenson
Jeffrey D
JD
Department of Anesthesiology, University of Utah School of Health Sciences, 30 North 1900 East, Salt Lake City, UT 84132, USA. jeff.swenson@hsc.utah.edu
Davis
Jennifer J
JJ
Johnson
Ken B
KB
D000698:Analgesia; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D004361:Drug Tolerance; D005283:Fentanyl; D006801:Humans; D009293:Opioid-Related Disorders / Q000150:complications*; D010149:Postoperative Pain / Q000188:drug therapy*; D011182:Postoperative Care; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000503:physiopathology
D000701:Analgesics, Opioid; D005283:Fentanyl