Postoperative Management - FREE NO CME-Postoperative Management

Video Transcription

Video Summary

In this comprehensive session on perioperative pain management, Dr. Don Stater, an emergency and addiction medicine physician, emphasizes a holistic approach anchored in five key elements: mind, movement, sleep/rest, food, and medicine. He highlights the importance of creating positive patient expectations to enhance analgesic efficacy while avoiding nocebo effects. Early mobilization and nutrition are underscored as crucial to recovery, alongside the use of multimodal analgesia to balance pain control and minimize opioid reliance.<br /><br />Dr. Stater reviews various pharmacological options: NSAIDs and acetaminophen as effective first-line non-opioids; the declining role of gabapentin; underutilized alpha-2 agonists like clonidine and tizanidine; IV lidocaine and ketamine as opioid-sparing adjuncts; and emerging agents like suzetragine. Corticosteroids have variable use, with caution in abdominal surgeries due to anastomotic leak risks. He stresses careful opioid prescribing, advocating for pain-guided opioid use rather than preventive dosing, and highlights opioid stewardship programs like Michigan OPEN that recommend tailored prescribing based on actual patient use.<br /><br />Patient education on opioid risks and safe medication storage is vital, as is co-prescription of naloxone for overdose prevention. Hospital policies impacting medication use, such as ketamine administration protocols, may need revision to facilitate best practices. Resources and ongoing education through Compass Health Collaborative support clinicians in optimizing postoperative pain care and recovery.

Keywords

perioperative pain management

multimodal analgesia

opioid stewardship

early mobilization

non-opioid analgesics

patient education

opioid-sparing adjuncts