title: Managing Opioid-Tolerant Patients in the Perioperative Surgical Home.
abstract: Management of acute postoperative pain is important to decrease perioperative morbidity and improve patient satisfaction. Opioids are associated with potential adverse events that may lead to significant risk. Uncontrolled pain is a risk factor in the transformation of acute pain to chronic pain. Balancing these issues can be especially challenging in opioid-tolerant patients undergoing surgery, for whom rapidly escalating opioid doses in an effort to control pain can be associated with increased complications. In the perioperative surgical home model, anesthesiologists are positioned to coordinate a comprehensive perioperative analgesic plan that begins with the preoperative assessment and continues through discharge.
authors.affiliation: Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Suite 8130, Gibbon Building, 111 South 11th Street, Philadelphia, PA 19107, USA. Electronic address: John.Wenzel@jefferson.edu.
authors.forename: John T
authors.initials: JT
authors.lastname: Wenzel
authors.affiliation: Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Suite 8130, Gibbon Building, 111 South 11th Street, Philadelphia, PA 19107, USA.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Schwenk
authors.affiliation: Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Suite 8130, Gibbon Building, 111 South 11th Street, Philadelphia, PA 19107, USA.
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Baratta
authors.affiliation: Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Suite 8130, Gibbon Building, 111 South 11th Street, Philadelphia, PA 19107, USA.
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Viscusi
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D004361:Drug Tolerance; D006801:Humans; D007430:Intraoperative Care; D007649:Ketamine / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy*; D011182:Postoperative Care; D011300:Preoperative Care
chemical_list: D000701:Analgesics, Opioid; D007649:Ketamine
keywords: Buprenorphine; Multimodal analgesia; Opioid tolerance; Perioperative surgical home