Date of Award

2018

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Skye Peltier

Abstract

Background: Surgical pain management with opioids is common. The use of multimodal analgesia has been proposed in order to provide opioid-sparing regimens and improve pain control post-operatively. Inadequate control of surgical pain can lead to development of chronic pain. Furthermore, studies have linked acute surgical opioid use to increased risk of long-term use. Long-term opioid use has undesirable, life-altering consequences, including physical dependence and addiction which may lead to overdose or death. Use of a variety of medications in the operative setting can lead to synergistic or additive effects on pain control, thus decreasing post-operative opioid consumption.

Methods: A literature review was conducted to answer the question of whether multimodal analgesic regimens decrease acute post-operative opioid consumption among opioid naive patients when compared to standard therapy. Discussion: Review of literature on single opioid-sparing as well as multimodal opioid-sparing medication techniques in short-stay surgery suggest methods for decreasing post-operative opioid consumption. Limitations include smaller study groups and varying multimodal analgesic protocols and surgical procedures evaluated aside from barriers on implementing such protocols. Conclusion: More consistent research is needed to evaluate specific multimodal analgesic protocols and use within specific types of surgeries. Review of the literature suggests that multimodal analgesic regimens have the capability to reduce acute post-operative opioid use in ambulatory surgical settings among opioid naive patients It will be key to identify individuals that are at higher risk for long-term opioid use in the preoperative stage in order to ensure implementation of multimodal analgesia at time of surgery. Research regarding the impact of multimodal analgesia on frequency of long term opioid use would be of benefit.

Identifier

SC11.PAS.2018.Hirsch.A

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Surgery Commons

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