Postoperative Management - CME Paid Option-Postoperative Management

Video Transcription

Video Summary

The presentation, led by Dr. Don Stater, focuses on perioperative pain management, emphasizing a multimodal approach aligned with Enhanced Recovery After Surgery (ERAS) protocols. Dr. Stater outlines five key aspects to postoperative care: mind (psychology and expectations), movement (early mobilization), sleep and rest, nutrition (early return to eating), and medications. Effective pain management requires addressing these areas to improve outcomes and reduce reliance on opioids.<br /><br />He highlights the importance of patient communication in creating positive expectations (placebo effect) to enhance pain medication efficacy and reduce the nocebo effect. Medications discussed include non-opioid options like NSAIDs and acetaminophen, with NSAIDs being effective when used judiciously; gabapentin’s perioperative use is declining due to limited efficacy and side effects. Clonidine, tizanidine, IV lidocaine, ketamine, corticosteroids, and the newer drug sugetrogene are reviewed as valuable adjuncts in multimodal analgesia.<br /><br />Post-discharge opioid stewardship is emphasized, advocating for using opioids only as rescue medications guided by pain, not preemptively, and ensuring safe prescribing based on data like that from Michigan Open. Naloxone co-prescribing is recommended to prevent overdose risks. The session stresses patient education, multidisciplinary collaboration, and protocol adaptation to optimize surgical pain management and promote recovery. Resources and continuous learning opportunities are provided through Compass Healthcare Collaborative.

Keywords

perioperative pain management

multimodal analgesia

Enhanced Recovery After Surgery (ERAS)

opioid stewardship

non-opioid pain medications

patient communication and expectations

postoperative care protocols