Opioid Stewardship in Practice: Safer Prescribing, Non-Opioid Strategies and Harm Reduction Across Care Settings-CME Paid Option-Module-2

Video Transcription

Video Summary

The session uses James, a 68-year-old postoperative patient with obstructive sleep apnea and chronic kidney disease, to show how to reduce opioid-related harm in high-risk hospitalized patients. Key points: older age, male sex, sleep-disordered breathing, and renal disease increase risk for opioid-induced respiratory depression. Safer care starts with early risk identification and multimodal, opioid-sparing pain management. Recommended strategies include ERAS protocols, scheduled non-opioids first (especially acetaminophen), cautious NSAID use in CKD, careful consideration or avoidance of gabapentin in renal disease, regional analgesia when feasible, and non-pharmacologic measures such as positioning, ice/heat, relaxation, TENS, and music therapy. If opioids are needed, use the lowest effective dose, preferably PRN rather than scheduled, and monitor sedation and respiratory status closely with nurse-driven hold parameters. Discharge prescribing should also be minimized and procedure-specific.

Keywords

opioid-related harm

postoperative patient

obstructive sleep apnea

chronic kidney disease

multimodal pain management