Surgical & Healthcare Alliance for enhanced Recovery & Pain Management (SHARP) Six Part Mini-Lecture Series-CME Paid Option-Comprehensive Perioperative Pain Management (1080p HD)

Video Transcription

Video Summary

Compass SHARP (Surgical and Healthcare Alliance for Enhanced Recovery and Pain Management) partners with Iowa Health and Human Services to provide free education and resources on perioperative opioid stewardship across the full surgical continuum—preop, intraop, and long after discharge. This lecture reviews the opioid epidemic: overdose deaths are now driven largely by illicit synthetic opioids (e.g., fentanyl), while prescription-opioid overdose deaths decreased about 12% from 2021–2022. Stewardship is needed because many patients with opioid use disorder first encounter opioids via prescriptions, opioid adverse drug events affect 10–14% of hospitalized surgical patients, and most patients have leftover pills after surgery. Core prescribing principles include prioritizing non-opioid therapies, using the lowest effective dose for the shortest time, favoring immediate-release oral monoproducts, avoiding long-acting/extended-release opioids (including fentanyl patches and methadone) in opioid-naïve patients, and reducing dose 25–50% when rotating opioids. Clinicians should prevent constipation proactively, avoid combining opioids with benzodiazepines and other sedatives, monitor function (not just pain scores), and avoid preop opioid prescriptions for opioid-naïve elective patients.

Keywords

perioperative opioid stewardship

enhanced recovery after surgery (ERAS)

non-opioid multimodal analgesia

opioid prescribing guidelines

fentanyl and synthetic opioid overdose epidemic