Preoperative Management-CME Paid Option-Preoperative Management (720p HD)

Video Transcription

Video Summary

Dr. Ha presents an overview of perioperative pain control focused on preoperative assessment and planning. She reviews key risk factors for persistent postsurgical pain and prolonged opioid use, including younger age, female sex, preexisting pain, psychological comorbidities (anxiety, depression, catastrophizing), smoking, obesity, certain surgeries (thoracic, breast, orthopedic, spine), and preoperative opioid or other substance use. A thorough preop evaluation should capture medical/psychiatric comorbidities, current analgesics and dosing, allergies, cognitive and social supports, prior surgical pain experiences, and patient goals.<br /><br />She discusses opioid misuse (using opioids other than prescribed) and notes limitations of existing screening tools (PMQ, SOAPP, ORT, COMM): they can help prompt discussion but don’t replace clinician assessment or longitudinal monitoring. She highlights the TAPS tool for systematically identifying substance use.<br /><br />Patient/family education and shared decision-making can reduce opioid prescribing and anxiety while improving satisfaction; studies in general surgery and post-cesarean patients show fewer tablets prescribed without worse pain outcomes. Additional preop optimization includes prehabilitation/physical therapy, smoking cessation, addressing heavy alcohol use, nutrition guidance, and cautious management of chronic opioids (generally continue; avoid rapid tapering immediately preop). She also reviews perioperative considerations for cannabis and medication-assisted treatment (methadone/buprenorphine), emphasizing multimodal, individualized plans and practical patient resources.

Keywords

perioperative pain management

preoperative assessment

persistent postsurgical pain risk factors

prolonged opioid use

opioid misuse screening tools

TAPS substance use tool

patient education and shared decision-making

multimodal analgesia planning