title: Perioperative pain management in the opioid-tolerant patient with chronic pain: an evidence-based practice project.
abstract: According to the Institute of Medicine (IOM) report on pain, chronic pain affects an estimated 116 million American adults and costs the nation more than $600 billion each year in medical treatment and lost worker productivity. Many individuals with chronic pain undergo surgical procedures. Safe and effective treatment of their postoperative pain can present a significant challenge to the health care team but is essential to their optimal recovery. Administrators in a community hospital in central Pennsylvania identified a need to improve the care of their patients with chronic pain and supported a hospital-wide initiative to address various aspects of this population's hospital experience. This article presents the first phase of an evidence-based practice project that focused on improving the perioperative pain management in patients with chronic pain who receive long-acting opioids for the treatment of chronic pain before admission for surgery.
authors.affiliation: Post Anesthesia Care Unit, York Hospital, 1001 S. George Street, York, PA 17405, USA. kdykstra@wellspan.org
authors.forename: Karen M
authors.initials: KM
authors.lastname: Dykstra
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002908:Chronic Disease; D004361:Drug Tolerance; D055317:Evidence-Based Practice; D006801:Humans; D059408:Pain Management; D010414:Pennsylvania; D019990:Perioperative Care
chemical_list: D000701:Analgesics, Opioid